Individual provider Active NPI

Forrest Craig, M.D.

  • Otolaryngology Physician
  • Fort Hood, TX
National Provider Identifier
1205249489
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
0101265197 Issued in VA
Practice address
36065 Santa Fe Ave
Fort Hood, TX 76544-5060
Phone
(317) 775-8682
NPI assigned
Jun 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 0101265197 VA Primary

Addresses

Primary practice location

36065 Santa Fe Ave
Fort Hood, TX 76544-5060

Mailing address

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 254-288-8000 Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240223002324 PA Practitioner - Otolaryngology 5395180897 Reassigns benefits to 1 organization
I20260413002602 IN Practitioner - Otolaryngology 5395180897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Indiana University School of Medicine, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1380 Adam LN
Belton, TX 76513-2272

1410 S Clark Blvd
Suite 2100
Clarksville, IN 47129-3212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101265197VAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jan 13, 2024 Accepting new patients
Geisinger Clinic CurrentSince Jan 13, 2024 Accepting new patients
Geisinger Clinic Current Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

Interoperability endpoints

  • Direct secure messaging: fcraig1324951@ahs.direct-ci.com

Organizations & group practices 4

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": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1205249489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36065 SANTA FE AVE",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765445060",
            "telephone_number": "317-775-8682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "FORREST",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-05",
        "last_updated": "2022-08-08",
        "certification_date": "2022-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101265197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "254-288-8000",
            "affiliation": "N",
            "endpointDescription": "clinic phone",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "36065 Santa Fe Ave",
            "city": "Fort Hood",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765445060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Hood, TX

Sources for this page

Verify at the official NPI Registry.