Crater Lake Acupuncture LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

CRATER LAKE ACUPUNCTURE LLC

Practice address

1245 N Riverside Ave Ste 14
Medford, OR 97501-4655

Phone

(541) 249-9200

Fax

(541) 262-4100

NPI assigned

Jul 10, 2019

Organization subpart

No

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

Authorized official

Name

Jennifer Long, D.A.O.M., L.AC.NPI 1215595178

Title

Owner of LLC

Phone

(541) 531-2151

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Long, L.AC

  • Acupuncturist
  • Grants Pass, OR
  • NPI 1215595178
  NPD Authorized official

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562716800000",
    "number": "1114579109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 ST AUGUSTINE DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975042154",
            "telephone_number": "541-531-2151",
            "fax_number": "541-262-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 N RIVERSIDE AVE STE 14",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975014655",
            "telephone_number": "541-249-9200",
            "fax_number": "541-262-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRATER LAKE ACUPUNCTURE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER OF LLC",
        "authorized_official_telephone_number": "541-531-2151",
        "authorized_official_credential": "D.A.O.M., L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Marie Cragg, PT, DPT, OCS
• Amanda Marie Cramer
• Kevin Michael Crane, MSW
• Craniosacral Therapy
• Crater Chiropractic Clinic PC
• Crater Lake Acupuncture LLC
• Crater Lake Surgery Center LLC
• Brad Crawford, RN BSN
• Hailey Nicole Crawford, PTA
• Holt Crawford

• Acupuncturist in Medford, OR
• Providers in Medford, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.