Individual provider Active NPI

Matthew Douglas Craig, D.C.

  • Chiropractor
  • Cooperstown, NY
National Provider Identifier
1750366431
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X011479 Issued in NY
Practice address
4910 State Highway 28
Cooperstown, NY 13326
Phone
(607) 282-4140
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X011479 NY Primary

Addresses

Primary practice location

4910 State Highway 28
Cooperstown, NY 13326

Mailing address

4910 State Highway 28
Cooperstown, NY 13326
Phone (607) 282-4140

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080318000352 NY Practitioner - Chiropractic 1557376621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4910 State Hwy 28
Cooperstown, NY 13326-5212
Phone (607) 282-4140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X011479NYMDChiropractor
011479NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperstown Family Chiorpractic, PLLC Chiropractor CurrentSince Feb 12, 2008 Accepting new patients
Mills Chiropractic Center Chiropractor PastSince Apr 16, 2001 Accepting new patients

Locations

4910 State Highway 28
Cooperstown, NY 13326
Phone (607) 282-4140

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1750366431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 STATE HIGHWAY 28",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "13326",
            "telephone_number": "607-282-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 STATE HIGHWAY 28",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "13326",
            "telephone_number": "607-282-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "MATTHEW",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.