Individual provider Active NPI

William C Woodcock, D.C.

  • Rehabilitation Chiropractor
  • Ellisville, MO
National Provider Identifier
1871851279
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
111NR0400X Issued in MO
Practice address
17 Clarkson Rd
Ellisville, MO 63011-5009
Phone
(636) 220-1500
Fax
(636) 220-1505
NPI assigned
Apr 24, 2012
Last updated
Jan 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 111NR0400X MO Primary

Addresses

Primary practice location

17 Clarkson Rd
Ellisville, MO 63011-5009

Mailing address

237 Blue Sage CT
B
Ballwin, MO 63011-5009
Phone (636) 346-8808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181108001105 ND Practitioner - Chiropractic 7012261142 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nagel Family Chiropractic and Wellness LLCGroup PAC ID 1153593876, 2 clinicians

Practice addresses (Care Compare)

2008 Twin City Dr
Mandan, ND 58554-3820
Phone (701) 214-6818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111NR0400XMOMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Apple Wellness, LLP CurrentSince Aug 24, 2018 Accepting new patients
Nagel Family Chiropractic and Wellness LLC CurrentSince Feb 1, 2022 Accepting new patients
Blue Apple Wellness, LLP CurrentSince Aug 24, 2018 Accepting new patients
Blue Apple Wellness, LLP Current Accepting new patients

Locations

1001 W Interstate Ave
Ste 108
Bismarck, ND 58503
Phone (701) 751-1541

1650 45th St S
Ste 113
Fargo, ND 58103
Phone (701) 532-0397

2008 Twin City Dr
Mandan, ND 58554
Phone (701) 214-6818

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1871851279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 BLUE SAGE CT",
            "address_2": "B",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630115009",
            "telephone_number": "636-346-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 CLARKSON RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630115009",
            "telephone_number": "636-220-1500",
            "fax_number": "636-220-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODCOCK",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-24",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MO",
            "license": "111NR0400X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellisville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.

Verify at the official NPI Registry.