Kyle J Cushing, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-006072 Issued in IL

Practice address

2823 Glenwood Ave
Rockford, IL 61101-3542

Phone

(815) 968-5342

Fax

(815) 968-4656

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Glenwood Center LTD

  • Psychiatry Physician
  • Rockford, IL
  • NPI 1003033861
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1346259157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 GLENWOOD AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611013542",
            "telephone_number": "815-968-5342",
            "fax_number": "815-968-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 GLENWOOD AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611013542",
            "telephone_number": "815-968-5342",
            "fax_number": "815-968-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSHING",
        "first_name": "KYLE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-006072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0010126129",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerin Cummins, APN
• William Kenneth Cunningham, MD
• Alane M Curry, PT, MPT
• Diane Lea Cushing, R.N., L.C.P.C.
• Frank Eugene Cushing, ED.D.
• Cyndie J Norton Professional Corporation
• Cynthia M. Sachs D.D.S., P.C.
• Gabrielle Czaja
• Michelle M. D'Almeida, DO
• Thomas Dace

• Clinical Psychologist in Rockford, IL
• Providers in Rockford, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.