Individual provider Active NPI

David Alan Cheesman, MD

  • Family Medicine Physician
  • Kokomo, IN
National Provider Identifier
1093766826
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01054637A Issued in IN
Practice address
1907 W Sycamore St
Kokomo, IN 46901-5148
Phone
(765) 456-5433
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01054637A IN Primary
Emergency Medicine Physician 207P00000X 01054637A IN

Addresses

Primary practice location

1907 W Sycamore St
Kokomo, IN 46901-5148

Mailing address

8840 Commerce Park PL Ste E
Indianapolis, IN 46268-3129

Other identifiers 1

IdentifierTypeStateIssuer
200420930MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061114000073 IN Practitioner - Family PracticePractitioner - Emergency Medicine 5890793541 Reassigns benefits to 2 organizations
I20181004000158 MI Practitioner - Family Practice 5890793541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

8240 Naab Rd
Suite 155
Indianapolis, IN 46260-1985
Phone (317) 338-7760

8333 Felch St
Zeeland, MI 49464-2608

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01054637AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Sep 24, 2018 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center Family Medicine CurrentSince Jun 30, 2010 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Feb 1, 2016 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Jun 30, 2010 Accepting new patients
Spectrum Health Primary Care Partners Family Medicine CurrentSince Sep 24, 2018 Accepting new patients
American Health Network of Indiana, LLC Family Medicine Past Accepting new patients
American Health Network of Indiana LLC Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

2015 Jackson St
Anderson, IN 46016
Phone (765) 646-8243

13500 N Meridian St
Carmel, IN 46032
Phone (317) 573-7000

13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

8240 Naab Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 338-7450

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

1907 W Sycamore St
Kokomo, IN 46901
Phone (765) 452-5611

1451 N Gardner St
Scottsburg, IN 47170
Phone (812) 752-8500

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: dcheesman237380@epic00.corewelldirect.org

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1093766826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8840 COMMERCE PARK PL STE E",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 W SYCAMORE ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469015148",
            "telephone_number": "765-456-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEESMAN",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01054637A",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01054637A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200420930",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.