Charlo Brandon Crumpacker, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1424 Molalla Ave
Oregon City, OR 97045-4004

Phone

(503) 744-4916

NPI assigned

Aug 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services - WashingtonGroup PAC ID 2860552973, 266 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Providence Health & Services - Washington

  • Family Medicine Physician
  • Walla Walla, WA
  • NPI 1922259738

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Washington

  • Emergency Medicine Physician
  • Walla Walla, WA
  • NPI 1699926402
  NPD
• Providence Health & Services - Washington

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  NPD (past)

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1003461823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352422941",
            "telephone_number": "423-682-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 MOLALLA AVE",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454004",
            "telephone_number": "503-744-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMPACKER",
        "first_name": "CHARLO",
        "middle_name": "BRANDON",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-08",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OR",
            "license": "63405",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Ann Cranfill, L.E.
• Credena Health LLC
• Taran McLeod Crocker, NBC-HIS
• Emily L Crowell, LCSW
• Kendra Crump
• Elisa Cruz, PA-C
• Alexandra Cuajao
• Lisa Cuneo, D.O.
• Jammie Mariah Cunha
• Jacqueline M Curry, B.A.

• Physical Therapist in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.