DR. MATTHEW DIRK WILLARD (NPI# 1619124286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619124286 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW DIRK WILLARD |
| Credential | DC |
| Practice Address |
141 Vinegar Hill Road Winston Salem NC 27104 |
| Mailing Address |
141 Vinegar Hill Rd Winston Salem NC 27104-5069 |
| Practice Telephone | 3364481894 |
| Practice Fax Number | 3364481895 |
| Mailing Telephone | 3364481894 |
| Mailing Fax Number | 3364481895 |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2013-01-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 3904 | NC | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MEDICARE GROUP PTAN | 2451497B | 01 |
| NC | 5950449 | 05 | |
| NC | BLUE CROSS PTAN | 086CJ | 01 |
| NC | MEDICARE PTAN | 2456085 | 01 |
| TAXONOMY | 111N00000X | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336360304 | Matthew Willard | Physician Assistant | 1 Toksook Bay Sub-regional Clinic, Toksook Bay, AK 99637 | 2007-05-01 |
| 1821577594 | Matthew Willard | Nurse Practitioner | 45 Wells St Ste 204, Westerly, RI 02891-2927 | 2018-08-13 |
| Street Address |
141 VINEGAR HILL ROAD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447807664 | Cameron Grant Ford | Psychologist | 614 Country Club Road, Winston-salem, NC 27104 | 2019-08-22 |
| 1104310374 | Novant Medical Group, Inc. | Internal Medicine | 4937 Old Country Club Rd, Winston Salem, NC 27104 | 2018-06-20 |
| 1982100509 | Dillon James Magalski | Student in an Organized Health Care Education/Training Program | Piedmont Plaza 1, 1920 West First Street, Wake Forest Baptist Medical Center, Winston-salem, NC 27104 | 2018-04-03 |
| 1891290144 | Breann M Poling | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center, Department Of, Family Medicine Piedmont Plaza I 1920 West First Street, Winston Salem, NC 27104 | 2018-03-28 |
| 1689178600 | Christopher Vasil | Student in an Organized Health Care Education/Training Program | Piedmont Plaza I, 1920 West First Street, Department of Family Medicine, Winston Salem, NC 27104 | 2018-03-23 |
| 1407379126 | April Lynn Lowe | Registered Nurse | 940 N Peace Haven Rd, Winstonsalem, NC 27104 | 2017-07-25 |
| 1164950804 | Donald Joyce | Student in an Organized Health Care Education/Training Program | 1920 West First St, Piedmont Plaza I Building, 3rd Floor, Winston-salem, NC 27104 | 2017-05-25 |
| 1255867289 | Benjamin Hansen | Pharmacist | 2150 Country Club Rd Ste 300, Winston Salem, NC 27104 | 2017-05-11 |
| 1770020976 | Jane Reed | Physical Medicine & Rehabilitation | 2627 E Greenbrier Road, Winston Salem, NC 27104 | 2017-01-25 |
| 1053728261 | Ashraf Alsaedi | Pharmacist | 1659 Stratford Rd Nw, Winston Salem, NC 27104 | 2014-07-20 |
| Find all providers in zip 27104 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558831701 | Sheri Ann Peacock | Chiropractor | 2544 Somerset Center Dr, Winston Salem, NC 27103-6766 | 2018-11-30 |
| 1447675855 | Amy M Shu | Chiropractor | 8007 N Point Blvd Ste B, Winston Salem, NC 27106-3268 | 2014-02-21 |
| 1710222864 | Twin City Chiropractic | Chiropractor | 3288 Robinhood Rd Ste 101, Winston Salem, NC 27106-5464 | 2012-11-30 |
| 1821320078 | Christopher Joseph Harris | Chiropractor | 205 S Stratford Rd, Suite L, Winston Salem, NC 27103-1871 | 2010-02-12 |
| 1982871117 | John Adrian Robinson | Chiropractor | 3300 Reynolda Rd, Winston Salem, NC 27106-3093 | 2008-05-16 |
| 1538363288 | Emilio L Zeolla | Chiropractor | 1515 Hanes Mall Blvd, Winston Salem, NC 27103-1358 | 2007-06-14 |
| 1487865531 | Roger A Miller | Chiropractor | 1495 Rymco Dr, Suite 107, Winston Salem, NC 27103-2947 | 2007-05-24 |
| 1326257890 | Steven George Liringis | Chiropractor | 3570 Vest Mill Rd Ste B, Winston Salem, NC 27103-2963 | 2007-05-22 |
| 1609081397 | Floyd J Strupe IIi | Chiropractor | 128 N Spruce St, Winston Salem, NC 27101 | 2007-05-14 |
| 1225155013 | Charles Alan Graham | Chiropractor | 1300 Ashley Sq, Winston Salem, NC 27103-2919 | 2007-03-25 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.