Individual provider Active NPI

Craig Louis Wilson, DC

  • Chiropractor
  • Cedar Springs, MI
National Provider Identifier
1588748313
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301004937 Issued in MI
Practice address
26 S Main
Box 279
Cedar Springs, MI 49319
Phone
(616) 696-2650
Fax
(616) 696-2650
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301004937 MI Primary

Addresses

Primary practice location

26 S Main
Box 279
Cedar Springs, MI 49319

Mailing address

1272 10 Mile Rd
Sparta, MI 49345
Phone (616) 887-8967

Other identifiers 3

IdentifierTypeStateIssuer
CW004937OtherBCBS LICENSE #
350045875OtherRAILROAD MEDICARE #
950D150030OtherBCBS PIN#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110312000091 MI Practitioner - Chiropractic 2062694060 Practice locations: Cedar Springs, MI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

26 S Main St
Cedar Springs, MI 49319-5118
Phone (616) 696-2650

26 S Main St Box
Suite 279
Cedar Springs, MI 49319-5118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301004937MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Springs Eye Care Inc PastSince Apr 1, 2004 Accepting new patients

Organizations & group practices 1

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1588748313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1272 10 MILE RD",
            "city": "SPARTA",
            "state": "MI",
            "postal_code": "49345",
            "telephone_number": "616-887-8967",
            "fax_number": "616-696-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 S MAIN",
            "address_2": "BOX 279",
            "city": "CEDAR SPRINGS",
            "state": "MI",
            "postal_code": "49319",
            "telephone_number": "616-696-2650",
            "fax_number": "616-696-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CRAIG",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301004937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS LICENSE #",
            "identifier": "CW004937",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE #",
            "identifier": "350045875",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN#",
            "identifier": "950D150030",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Springs, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; 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.