Individual provider Active NPI

Lance Michon Craig, MD

  • General Practice Physician
  • Concord, NC
National Provider Identifier
1295355220
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
100735 Issued in GA
Practice address
270 Copperfield Blvd NE Ste 101
Concord, NC 28025-2443
Phone
(704) 786-6521
Fax
(704) 782-9703
NPI assigned
Apr 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 261851 NC
General Practice Physician 208D00000X 100735 GA Primary

Addresses

Primary practice location

270 Copperfield Blvd NE Ste 101
Concord, NC 28025-2443

Mailing address

270 Copperfield Blvd NE Ste 202
Concord, NC 28025-2441
Phone (704) 721-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241016003405 GA Practitioner - Family Practice 4486078409 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Atlanta Urgent Care Clinic LLC CurrentSince Sep 1, 2024 Accepting new patients
Swift Health Medical Group CurrentSince Sep 1, 2024 Accepting new patients

Locations

5185 Old National Hwy
College Park, GA 30349
Phone (404) 763-9300

6053 Jonesboro Rd
Morrow, GA 30260
Phone (770) 824-4343

Organizations & group practices 2

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": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1295355220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 COPPERFIELD BLVD NE STE 202",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252441",
            "telephone_number": "704-721-2020",
            "fax_number": "704-403-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 COPPERFIELD BLVD NE STE 101",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252443",
            "telephone_number": "704-786-6521",
            "fax_number": "704-782-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "LANCE",
        "middle_name": "MICHON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-20",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "261851",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "100735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.