Benjamin Philip Pushard, ATC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

CR2036 Issued in ME

Practice address

270 Wilson St
Same
Brewer, ME 04412-1548

Phone

(207) 989-4401

NPI assigned

Aug 6, 2018

Last updated

Aug 6, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1811475403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 WILSON ST",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121548",
            "telephone_number": "207-989-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 WILSON ST",
            "address_2": "SAME",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121548",
            "telephone_number": "207-989-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSHARD",
        "first_name": "BENJAMIN",
        "middle_name": "PHILIP",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-06",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "ME",
            "license": "CR2036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Physician Chiropractor in Brewer, ME
• Providers in Brewer, ME by specialty
• Sports Physician Chiropractor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.