Active NPI
Jack Lee Crain, M.D.
- Specialist
- Charlotte, NC
National Provider Identifier
1073583555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 1524 E Morehead St
Charlotte, NC 28207-1606 - Phone
- (704) 343-4452
- Fax
- (704) 343-3428
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | NC | Primary |
Addresses
Primary practice location
1524 E Morehead St
Charlotte, NC 28207-1606
Mailing address
1524 E Morehead St
Charlotte, NC 28207-1606
Phone (704) 343-4452
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200001202683 | Other | NC | PHYS PRIVILEGE LICENSE |
| 28480 | Other | NC | MEDICAL BOARD LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000-28480 | NC | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1073583555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1524 E MOREHEAD ST",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282071606",
"telephone_number": "704-343-4452",
"fax_number": "704-343-3428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1524 E MOREHEAD ST",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282071606",
"telephone_number": "704-343-4452",
"fax_number": "704-343-3428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAIN",
"first_name": "JACK",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYS PRIVILEGE LICENSE",
"identifier": "200001202683",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL BOARD LICENSE",
"identifier": "28480",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.