Active NPI
Craig David Pearson, D.C.
- Chiropractor
- Boulder, CO
National Provider Identifier
1326076936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4464
- Practice address
- 2625 28TH St
Ste 100
Boulder, CO 80301-1263 - Phone
- (303) 402-1300
- Fax
- (303) 402-1310
- NPI assigned
- Jun 30, 2006
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4464 | CO | Primary |
Addresses
Primary practice location
2625 28TH St
Ste 100
Boulder, CO 80301-1263
Mailing address
2625 28TH St
Ste 100
Boulder, CO 80301-1263
Phone (303) 402-1300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110315000335 | CO | Practitioner - Chiropractic | 3173705084 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4464 | CO | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311638400000",
"number": "1326076936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 28TH ST",
"address_2": "STE 100",
"city": "BOULDER",
"state": "CO",
"postal_code": "803011263",
"telephone_number": "303-402-1300",
"fax_number": "303-402-1310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2625 28TH ST",
"address_2": "STE 100",
"city": "BOULDER",
"state": "CO",
"postal_code": "803011263",
"telephone_number": "303-402-1300",
"fax_number": "303-402-1310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "CRAIG",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2011-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CO",
"license": "4464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.