Active NPI
Chad Craft, PA-C
- Physician Assistant
- San Diego, CA
National Provider Identifier
1114337193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1095572
- Practice address
- 12194 Waverly Downs LN
San Diego, CA 92128-3708 - Phone
- (858) 531-1391
- NPI assigned
- Apr 30, 2014
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1095572 | Primary |
Addresses
Primary practice location
12194 Waverly Downs LN
San Diego, CA 92128-3708
Mailing address
12194 Waverly Downs LN
San Diego, CA 92128-3708
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1095572 | Other | NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398816000000",
"number": "1114337193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12194 WAVERLY DOWNS LN",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921283708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12194 WAVERLY DOWNS LN",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921283708",
"telephone_number": "858-531-1391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAFT",
"first_name": "CHAD",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-30",
"last_updated": "2014-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": "1095572",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS",
"identifier": "1095572",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.