Active NPI
Stacy Craig
- Skilled Nursing Facility
- Raleigh, NC
National Provider Identifier
1104180967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 3659
- Practice address
- 3001 Spring Forest Rd
Raleigh, NC 27616-2815 - Phone
- (910) 692-7293
- NPI assigned
- Jun 26, 2012
- 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 |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 3659 | NC | Primary |
Addresses
Primary practice location
3001 Spring Forest Rd
Raleigh, NC 27616-2815
Mailing address
507 Kerr Lake Rd
Aberdeen, NC 28315-7056
Phone (704) 798-3800
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3659 | NC | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340668800000",
"number": "1104180967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 KERR LAKE RD",
"city": "ABERDEEN",
"state": "NC",
"postal_code": "283157056",
"telephone_number": "704-798-3800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 SPRING FOREST RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276162815",
"telephone_number": "910-692-7293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAIG",
"first_name": "STACY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-26",
"last_updated": "2012-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NC",
"license": "3659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.