Individual provider Active NPI

Craig Allan Gill, B.S., D.C.

  • Chiropractor
  • Westland, MI
National Provider Identifier
1609826197
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301007039 Issued in MI
Practice address
2505 S Wayne Rd
Westland, MI 48186-5431
Phone
(734) 721-1516
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301007039 MI Primary

Addresses

Primary practice location

2505 S Wayne Rd
Westland, MI 48186-5431

Mailing address

2505 S Wayne Rd
Westland, MI 48186-5431
Phone (734) 721-1516

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080829000038 MI Practitioner - Chiropractic 2668548579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1994
Medicare assignment
May accept Medicare assignment
Group practices
Diverse Health Services PLLCGroup PAC ID 9739282534, 3 clinicians

Practice addresses (Care Compare)

24230 Karim Blvd
Novi, MI 48375-2953
Phone 2484770380112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Diverse Health Services PLLC Chiropractor CurrentSince Nov 2, 2020 Accepting new patients

Locations

24230 Karim Blvd
Ste 130
Novi, MI 48375
Phone (248) 477-0380

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1609826197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 S WAYNE RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481865431",
            "telephone_number": "734-721-1516",
            "fax_number": "734-721-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 S WAYNE RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481865431",
            "telephone_number": "734-721-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "CRAIG",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "B.S., D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.