Organization Active NPI

Cusack Chiropractic Prof Corp

  • Chiropractor
  • Walnut Creek, CA
National Provider Identifier
1467523316
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CUSACK CHIROPRACTIC PROF CORP
Practice address
2801 Ygnacio Valley Road
Suite B
Walnut Creek, CA 94598
Phone
(925) 945-0555
Fax
(925) 945-1873
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gregory John Cusack, DC
Title
President Owner
Phone
(925) 945-0555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2801 Ygnacio Valley Road
Suite B
Walnut Creek, CA 94598

Mailing address

2801 Ygnacio Valley Rd
Suite B
Walnut Creek, CA 94598
Phone (925) 945-0555

Other names 1

  • Corporation Other name

National Provider Directory

National Provider Directory

Locations

2801 Ygnacio Valley Rd
Ste B
Walnut Creek, CA 94598
Phone (925) 945-0555

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467523316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 YGNACIO VALLEY RD",
            "address_2": "SUITE B",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94598",
            "telephone_number": "925-945-0555",
            "fax_number": "925-945-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 YGNACIO VALLEY ROAD",
            "address_2": "SUITE B",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94598",
            "telephone_number": "925-945-0555",
            "fax_number": "925-945-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSACK CHIROPRACTIC PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CUSACK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "925-945-0555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.