Individual provider Active NPI

Cevin Charles Cormier, D.C.

  • Chiropractor
  • Mobile, AL
National Provider Identifier
1326100280
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1894 Issued in AL
Practice address
6300 Airport Blvd
C
Mobile, AL 36608-3161
Phone
(251) 343-9990
Fax
(251) 343-9181
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH3099 AL
Chiropractor 111N00000X 1894 AL Primary

Addresses

Primary practice location

6300 Airport Blvd
C
Mobile, AL 36608-3161

Mailing address

6300 Airport Blvd
C
Mobile, AL 36608-3161
Phone (251) 343-9990

Other identifiers 2

IdentifierTypeStateIssuer
000021855OtherALPTAN
510I650143OtherALPTAN FOR PT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 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
I20050119000637 AL Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 0840249645 Reassigns benefits to 1 organization
I20080630000569 AL Practitioner - Physical Therapist in Private Practice 0840249645 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH3099ALMDPhysical Therapist

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1326100280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 AIRPORT BLVD",
            "address_2": "C",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083161",
            "telephone_number": "251-343-9990",
            "fax_number": "251-343-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 AIRPORT BLVD",
            "address_2": "C",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083161",
            "telephone_number": "251-343-9990",
            "fax_number": "251-343-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORMIER",
        "first_name": "CEVIN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH3099",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "000021855",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN FOR PT",
            "identifier": "510I650143",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.