Individual provider Active NPI

Craig Derek Cushman, D.C.

  • Chiropractor
  • Greenville, MI
National Provider Identifier
1174883748
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009824 Issued in MI
Practice address
710 E Washington St
Greenville, MI 48838-2054
Phone
(616) 754-9172
Fax
(616) 754-1067
NPI assigned
May 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009824 MI Primary

Addresses

Primary practice location

710 E Washington St
Greenville, MI 48838-2054

Mailing address

710 E Washington St
Greenville, MI 48838-2054
Phone (616) 754-9172

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120601000116 MI Practitioner - Chiropractic 7911160999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hayes Chiropractic Clinic PCGroup PAC ID 6709804412, 2 clinicians

Practice addresses (Care Compare)

710 E Washington St
Greenville Chiropractic Clinic PC
Greenville, MI 48838-2054
Phone (616) 754-9172

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dekraker Cushman PC Chiropractor PastSince Aug 6, 2017 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1174883748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 E WASHINGTON ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382054",
            "telephone_number": "616-754-9172",
            "fax_number": "616-754-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 E WASHINGTON ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382054",
            "telephone_number": "616-754-9172",
            "fax_number": "616-754-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSHMAN",
        "first_name": "CRAIG",
        "middle_name": "DEREK",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-17",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.