Holly Nichole Willison, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

34769 Issued in CA

Practice address

2250 S Main St Ste 203
Corona, CA 92882-2506

Phone

(800) 595-2447

NPI assigned

Mar 31, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Holly Nichole Stephens Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Los Angeles College of Chiropractic, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Medical Center of Corona IncGroup PAC ID 4981904737, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Integrated Medical Center of Corona Inc.

  • Multi-Specialty Clinic/Center
  • Corona, CA
  • NPI 1023400322
  Medicare reassignment Care Compare group NPD
• Pirritano Chiropractic Corporation

  dba Chiropractic Injury Care and Prevention Network

  • Chiropractor
  • Corona, CA
  • NPI 1952496028
  NPD (past)

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1942838255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST STE 203",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822506",
            "telephone_number": "800-595-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 S MAIN ST STE 203",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822506",
            "telephone_number": "800-595-2447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12598 Central Ave Ste 120A",
            "address_purpose": "LOCATION",
            "city": "Chino",
            "state": "CA",
            "postal_code": "917103530",
            "country_code": "US",
            "telephone_number": "909-464-9811",
            "fax_number": "909-464-0136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLISON",
        "first_name": "HOLLY",
        "middle_name": "NICHOLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "STEPHENS",
            "middle_name": "NICHOLE",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Rina Williams, RPH
• Christina Willis
• Daron Willis
• Imani Willis
• Brandi Willoughby
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• Wilshire Oncology Medical Group Inc
• Cory Wilson
• Jessica Wynn Wilson, LMFT

• Chiropractor in Corona, CA
• Providers in Corona, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.