Active NPI
S. Marshall Cushman, M.D.
- Neurological Surgery Physician
- Racine, WI
National Provider Identifier
1679672430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 14010
- Practice address
- 3805B Spring St Ste 320
Racine, WI 53405-1644 - Phone
- (262) 687-8322
- NPI assigned
- Sep 21, 2006
- Last updated
- Apr 1, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 14010 | WI | Primary |
Addresses
Primary practice location
3805B Spring St Ste 320
Racine, WI 53405-1644
Mailing address
3831 Lighthouse Drive
Racine, WI 53402
Phone (262) 639-8925
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14010 | WI | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurological Clinic, SC | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinic/Center
- Annandale, VA
- NPI 1144879206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238544000000",
"number": "1679672430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3831 LIGHTHOUSE DRIVE",
"city": "RACINE",
"state": "WI",
"postal_code": "53402",
"telephone_number": "262-639-8925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3805B SPRING ST STE 320",
"city": "RACINE",
"state": "WI",
"postal_code": "534051644",
"telephone_number": "262-687-8322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUSHMAN",
"first_name": "S.",
"middle_name": "MARSHALL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2009-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "WI",
"license": "14010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.