RANDY JOE WILLIS D.C.
NPI 1780632422
Chiropractor in Kannapolis, NC
About Randy Joe Willis D.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RANDY JOE WILLIS D.C. (NPI 1780632422) is an individual chiropractor in Kannapolis, North Carolina, licensed in North Carolina (3043) and active in the NPI registry since May 2006.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Randy Joe Willis D.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Randy Willis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Kannapolis, NC 28081
- Reassigned Medicare billing, North Carolina enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Randy Willis's NPI number?
The NPI number for Randy Willis is 1780632422. It was assigned to this individual provider in the NPPES registry on May 5, 2006.
Where is Randy Willis located?
Randy Willis practices at 607 Rainbow Dr, Kannapolis, NC 28081. The listed phone number is (704) 652-1393.
What is Randy Willis's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Randy Willis enrolled in Medicare?
Yes. Randy Willis is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Randy Willis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Randy Willis reassigns Medicare benefits to Fidelity Chiropractic, PLLC (Kannapolis, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Randy Willis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Randy Willis was last updated on March 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Randy Joe Willis, D.C. · NPI 1780632422
Chiropractor provider in Kannapolis, North Carolina. Individual provider, active in the CMS NPPES registry since May 5, 2006.
## Identity
- **NPI:** 1780632422 (Entity type: Individual)
- **Enumerated:** May 5, 2006
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **State license:** 3043 (North Carolina)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 607 RAINBOW DR, Kannapolis, NC 28081-4746
- **Phone:** (704) 652-1393
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Fidelity Chiropractic, PLLC (NPI 1619019858, Kannapolis, NC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 25, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1780632422) · Data from the CMS NPPES public registry.