Active NPI
William Wilkerson III, D.C
- Chiropractor
- Leesville, LA
National Provider Identifier
1790874469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1490
- Practice address
- 802 S 10TH St
Suite B
Leesville, LA 71446-4612 - Phone
- (337) 238-5338
- Fax
- (337) 238-5340
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC29021 | CA | |
| Chiropractor | 111N00000X | 1490 | LA | Primary |
Addresses
Primary practice location
802 S 10TH St
Suite B
Leesville, LA 71446-4612
Mailing address
802 S 10TH St
Suite B
Leesville, LA 71446-4612
Phone (337) 238-5338
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC0290210 | Other | CA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090119000098 | LA | Practitioner - Chiropractic | 2769479633 | Practice locations: Leesville, LA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
802 S 10 St B
Leesville Family Chiropractic
Leesville, LA 71446-4612
Phone (337) 238-5338
802 S 10TH St
Suite B
Leesville, LA 71446-4612
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229472000000",
"number": "1790874469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 S 10TH ST",
"address_2": "SUITE B",
"city": "LEESVILLE",
"state": "LA",
"postal_code": "714464612",
"telephone_number": "337-238-5338",
"fax_number": "337-238-5340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 S 10TH ST",
"address_2": "SUITE B",
"city": "LEESVILLE",
"state": "LA",
"postal_code": "714464612",
"telephone_number": "337-238-5338",
"fax_number": "337-238-5340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKERSON",
"first_name": "WILLIAM",
"name_suffix": "III",
"credential": "D.C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2008-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC29021",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "LA",
"license": "1490",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "DC0290210",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Leesville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.