Active NPI
Michelle Lynn Cradit, PSS
- Peer Specialist
- McMinnville, OR
National Provider Identifier
1013553700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 640 NE 3Rd St
McMinnville, OR 97128-4630 - Phone
- (503) 474-5509
- NPI assigned
- Nov 18, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
640 NE 3Rd St
McMinnville, OR 97128-4630
Mailing address
239 SE Baker St
Unit B
McMinnville, OR 97128-6076
Phone (971) 241-5831
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| THW000001779 | Other | OR | OREGON HEALTH AUTHORITY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574035200000",
"number": "1013553700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "239 SE BAKER ST",
"address_2": "UNIT B",
"city": "MCMINNVILLE",
"state": "OR",
"postal_code": "971286076",
"telephone_number": "971-241-5831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 NE 3RD ST",
"city": "MCMINNVILLE",
"state": "OR",
"postal_code": "971284630",
"telephone_number": "503-474-5509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRADIT",
"first_name": "MICHELLE",
"middle_name": "LYNN",
"credential": "PSS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-18",
"last_updated": "2019-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON HEALTH AUTHORITY",
"identifier": "THW000001779",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in McMinnville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.