Craig Raymond Nicholson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4689 Issued in MT

Practice address

1203 15TH St
Fort Benton, MT 59442

Phone

(406) 622-5485

Fax

(406) 622-3882

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Not Tsoo Gah Nee Indian Health

  • Health Service Clinic/Center
  • Fort Hall, ID
  • NPI 1558441139
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1306853742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "FORT BENTON",
            "state": "MT",
            "postal_code": "594420249",
            "telephone_number": "406-622-5485",
            "fax_number": "406-622-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 15TH ST",
            "city": "FORT BENTON",
            "state": "MT",
            "postal_code": "59442",
            "telephone_number": "406-622-5485",
            "fax_number": "406-622-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "CRAIG",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "4689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0153166",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Maestas, PA-C
• Chase Alexander McGlinchey, PA
• Memorial Ambulance of Fort Benton Montana
• Montana Therapy
• Dawn M Nelson, P.T.
• Pawsitive Healing Counseling
• Carol Georgeanne Richard
• Jaynee Christine Robinson
• Kelly Marie Rominger
• Heather Lynn Smith, BSN, MSN

• Family Medicine Physician in Fort Benton, MT
• Providers in Fort Benton, MT by specialty
• Family Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.