Individual provider Active NPI

Kenneth Paul McCauley, DC

  • Chiropractor
  • Rochester, MI
National Provider Identifier
1376653477
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0190334 Issued in MI
Practice address
115 S Main St
Rochester, MI 48307-2032
Phone
(248) 650-5525
Fax
(248) 650-5544
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0190334 MI Primary

Addresses

Primary practice location

115 S Main St
Rochester, MI 48307-2032

Mailing address

115 S Main St
Rochester, MI 48307-2032
Phone (248) 650-5525

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040518000719 MI Practitioner - Chiropractic 0840280012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Lincoln Chiropractic College, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

115 S Main St
Rochester, MI 48307-2032
Phone (248) 650-5525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0190334MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Family Chiropractic Center PC Chiropractor Past 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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1376653477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S MAIN ST",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483072032",
            "telephone_number": "248-650-5525",
            "fax_number": "248-650-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S MAIN ST",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483072032",
            "telephone_number": "248-650-5525",
            "fax_number": "248-650-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAULEY",
        "first_name": "KENNETH",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "0190334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.