Individual provider Active NPI

Matthew Crawford

  • Chiropractor
  • Fort Wayne, IN
National Provider Identifier
1710533633
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003101A Issued in IN
Practice address
3417 E State Blvd
Fort Wayne, IN 46805-4830
Phone
(260) 387-6218
NPI assigned
Aug 15, 2019
Last updated
Aug 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08003101A IN Primary

Addresses

Primary practice location

3417 E State Blvd
Fort Wayne, IN 46805-4830

Mailing address

3417 E State Blvd
Fort Wayne, IN 46805-4830

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230425002112 IN Practitioner - Chiropractic 1951766096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryan Bingham D.C., P.C.Group PAC ID 6800953506, 2 clinicians

Practice addresses (Care Compare)

5420 N College Ave
Suite 101
Indianapolis, IN 46220-3169
Phone (317) 257-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08003101AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Bingham D.C., P.C. Chiropractor CurrentSince Apr 10, 2023 Accepting new patients
Spine Center of Fort Wayne Chiropractor PastSince Aug 18, 2019 Accepting new patients

Locations

5420 N College Ave
Ste 10
Indianapolis, IN 46220
Phone (317) 257-2800

5420 N College Ave
Ste 101
Indianapolis, IN 46220
Phone (317) 257-2800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1710533633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054830",
            "telephone_number": "260-387-6218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003101A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.