Individual provider Active NPI

Evan J Perry, D.C.

  • Chiropractor
  • Rockford, MI
National Provider Identifier
1073856621
Registry record updated Jan 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010008 Issued in MI
Practice address
515 E Division St Ste 130
Rockford, MI 49341-1378
Phone
(616) 884-0060
NPI assigned
Apr 2, 2013
Last updated
Jan 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010008 MI Primary

Addresses

Primary practice location

515 E Division St Ste 130
Rockford, MI 49341-1378

Mailing address

515 E Division St Ste 130
Rockford, MI 49341-1378
Phone (616) 884-0060

Other practice location 1

997 N Center Ave
Gaylord, MI 49735-9375
Phone (989) 732-2225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140117001722 MI Practitioner - Chiropractic 0345478467 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cousineau Chiropractic Center PLLCGroup PAC ID 3173690906, 2 clinicians

Practice addresses (Care Compare)

515 E Division St
Suite 130
Rockford, MI 49341-1378
Phone (616) 884-0060

997 N Ctr Ave
Gaylord, MI 49735-9375
Phone (989) 732-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301010008MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cousineau Chiropractic Center PLLC Chiropractor CurrentSince Nov 1, 2013 Accepting new patients
Adapt Chiropractic PLLC Chiropractor CurrentSince Jan 1, 2025 Accepting new patients

Locations

997 N Center Ave
Gaylord, MI 49735
Phone (989) 705-8555

515 E Division St
Ste 130
Rockford, MI 49341
Phone (616) 884-0060

Organizations & group practices 2

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": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737763200000",
    "number": "1073856621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 E DIVISION ST STE 130",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411378",
            "telephone_number": "616-884-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E DIVISION ST STE 130",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411378",
            "telephone_number": "616-884-0060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "997 N Center Ave",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "497359375",
            "country_code": "US",
            "telephone_number": "989-732-2225",
            "fax_number": "989-731-6776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "EVAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-02",
        "last_updated": "2025-01-25",
        "certification_date": "2025-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2025; 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.