Jacob Steven Crawford, DPT, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-5291 Issued in ID

Practice address

1673 W Shoreline Dr Ste 230
Boise, ID 83702-6752

Phone

(208) 343-4700

Fax

(208) 343-4706

NPI assigned

Jul 27, 2017

Last updated

Jul 27, 2017By the provider in NPPES

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 names 1

• Jake Steven Crawford Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1346764701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 E STATE ST STE 101",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165915",
            "telephone_number": "208-939-9594",
            "fax_number": "208-939-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1673 W SHORELINE DR STE 230",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026752",
            "telephone_number": "208-343-4700",
            "fax_number": "208-343-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "JACOB",
        "middle_name": "STEVEN",
        "credential": "DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-27",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-5291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAKE",
            "last_name": "CRAWFORD",
            "middle_name": "STEVEN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Heather D Craven, OTR/L
• Spencer John Craven, M.D.
• Gregory Forest Cravens, R.PH
• Amber Richele Crawford, COTA/L
• David Crawford, LPC
• Lindsay Dawn Crawford, PHARM.D.
• Rachael Ann Crawford, ATC
• Robert G Crawford, CST, CFA
• Russell D Crawford, DO
• Danielle Cremer

• Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; 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.