Individual provider Active NPI

Kenneth James Cushman, D.C.

  • Chiropractor
  • Owosso, MI
National Provider Identifier
1073785937
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009446 Issued in MI
Practice address
1424 N M 52
Owosso, MI 48867-1235
Phone
(989) 923-2225
NPI assigned
Mar 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009446 MI Primary

Addresses

Primary practice location

1424 N M 52
Owosso, MI 48867-1235

Mailing address

1424 N M 52
Owosso, MI 48867-1235
Phone (989) 923-2225

Other practice location 1

5108 Eastman Ave
ste 1
Midland, MI 48640-6823
Phone (989) 923-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080616000592 MI Practitioner - Chiropractic 9739250945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Shiawassee Spinal Center PCGroup PAC ID 6103183280, 2 clinicians

Practice addresses (Care Compare)

1424 N M
Suite 52
Owosso, MI 48867-1235
Phone (989) 720-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3910NCMDProfessional Counselor
2301009446MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Shiawassee Spinal Center, PC Chiropractor CurrentSince Jan 1, 2018 Accepting new patients
The Apple Valley Clinic of Chiropractic, PLLC Chiropractor PastSince Aug 4, 2024 Accepting new patients
Simmons Specific Chiropractic P C Chiropractor Past Accepting new patients

Locations

1424 N M 52
Owosso, MI 48867
Phone (989) 720-2225

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1073785937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 N M 52",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671235",
            "telephone_number": "989-923-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 N M 52",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671235",
            "telephone_number": "989-923-2225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5108 Eastman Ave",
            "address_2": "ste 1",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "MI",
            "postal_code": "486406823",
            "country_code": "US",
            "telephone_number": "989-923-2225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUSHMAN",
        "first_name": "KENNETH",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owosso, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.