Organization Active NPI

Craig D Anderson MD PC

  • Pain Medicine (Anesthesiology) Physician
  • Salem, OR
National Provider Identifier
1073558789
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
CRAIG D ANDERSON MD PC
Practice address
4999 Skyline Rd S
Suite 100
Salem, OR 97306-2009
Phone
(503) 371-4647
NPI assigned
Jun 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Authorized official

Name
Craig Douglas Anderson, MD
Title
President
Phone
(503) 371-4647

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

4999 Skyline Rd S
Suite 100
Salem, OR 97306-2009

Mailing address

PO Box 4008
Portland, OR 97208-4008
Phone (503) 372-2740

Other identifiers 1

IdentifierTypeStateIssuer
DC8908OtherORRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

4999 Skyline Rd S
Ste 100A
Salem, OR 97306
Phone (503) 370-5200

4999 Skyline Rd S
Ste 100B
Salem, OR 97306
Phone (503) 371-4647

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1073558789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4008",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084008",
            "telephone_number": "503-372-2740",
            "fax_number": "503-372-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4999 SKYLINE RD S",
            "address_2": "SUITE 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973062009",
            "telephone_number": "503-371-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG D ANDERSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-371-4647",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC8908",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.