Individual provider Active NPI

Clint I Craig, DPT

  • Physical Therapist
  • Lakewood, OH
National Provider Identifier
1104229194
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
013909 Issued in OH
Practice address
1313 Granger Ave
Lakewood, OH 44107-2232
Phone
(419) 302-3939
NPI assigned
Oct 3, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 013909 OH Primary

Addresses

Primary practice location

1313 Granger Ave
Lakewood, OH 44107-2232

Mailing address

1313 Granger Ave
Lakewood, OH 44107-2232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170926002500 OH Practitioner - Physical Therapist in Private Practice 9537433842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Orthopedics and Physical Therapy, Inc.Group PAC ID 6204096050, 6 clinicians

Practice addresses (Care Compare)

4700 Richmond Rd
Suite 100
Warrensville Heights, OH 44128-5985
Phone (216) 378-9390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013909OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopedics and Physical Therapy, Inc. CurrentSince Jun 9, 2017 Accepting new patients

Locations

3310 Warren Rd
Cleveland, OH 44111
Phone (216) 476-1700

26250 Euclid Ave
Ste 711
Euclid, OH 44132
Phone (216) 261-7715

4700 Richmond Rd
Ste 100
Warrensville Heights, OH 44128
Phone (216) 378-9390

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.

NPI Registry JSON

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1104229194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 GRANGER AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 GRANGER AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072232",
            "telephone_number": "419-302-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "CLINT",
        "middle_name": "I",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-03",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "013909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.