Individual provider Active NPI

Craig Robert Schumann, PA-C

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1063764629
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA22629 Issued in CA
Practice address
1160 E 3900 S Ste 5000
Salt Lake City, UT 84124-1275
Phone
(801) 261-7479
Fax
(801) 261-7429
NPI assigned
Oct 8, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA22629 CA Primary

Addresses

Primary practice location

1160 E 3900 S Ste 5000
Salt Lake City, UT 84124-1275

Mailing address

PO Box 100253
Atlanta, GA 30384-0253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160802001209 UT Practitioner - Physician Assistant 0042461642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountainstar Specialty Services LLCGroup PAC ID 4688767551, 30 clinicians

Practice addresses (Care Compare)

1160 E 3900
Suite 5000
Salt Lake City, UT 84124-1275
Phone (801) 262-8486

1200 E 3900
Salt Lake City, UT 84124-1300

8846 S Redwood Rd
Suite 121
West Jordan, UT 84088-9366
Phone (801) 569-1999

Hospital & facility affiliations

  • St Mark'S Hospital Hospital, Salt Lake City, UT, CCN 460047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1063764629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100253",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 E 3900 S STE 5000",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241275",
            "telephone_number": "801-261-7479",
            "fax_number": "801-261-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUMANN",
        "first_name": "CRAIG",
        "middle_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-08",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.