Craig J Everingham, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

381898373 Issued in MI

Practice address

12100 S Huron River Dr
Romulus, MI 48174-1119

Phone

(734) 941-1070

Fax

(734) 941-1763

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Interoperability endpoints

• Direct secure messaging: ceveringham120511@direct.beaumont.edu

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.

• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1891796371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1863",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 S HURON RIVER DR",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481741119",
            "telephone_number": "734-941-1070",
            "fax_number": "734-941-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERINGHAM",
        "first_name": "CRAIG",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "381898373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5820103",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1290362 TYPE 11",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ceveringham120511@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "12100 S Huron River Dr",
            "city": "Romulus",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481741119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Epoch LLC
• Essential Care Case Management
• Denzel Evans
• Everingham Chiropractic Health Center, P.C.
• Everingham Clinic PC
• Craig James Everingham, D.C.
• Everwell Counseling LLC
• Express Docs Urgent Care PLLC
• Fairway Transportation LLC
• Courtney Lynn Fankhauser, CTRS

• Family Medicine Physician in Romulus, MI
• Providers in Romulus, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.