Individual provider Active NPI

Joseph Gordon Krainin, MD

  • Neurology Physician
  • Charleston, SC
National Provider Identifier
1386792307
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME117836 Issued in FL
Practice address
171 Ashley Ave
Charleston, SC 29425-8908
Phone
(843) 792-1414
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 37156 SC
Neurology Physician 2084N0400X MD60603804 WA
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 4301091617 MI
Neurology Physician 2084N0400X ME117836 FL Primary
Neurology Physician 2084N0400X DR.0057012 CO

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-8908

Mailing address

2 Shircliff Way
Ste 300
Jacksonville, FL 32204-4765
Phone (904) 308-7959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, FL, OR, MA4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20141020001987 SC Practitioner - Neurology 2567557176 Reassigns benefits to 1 organization
I20160217001624 FL Practitioner - Sleep Medicine 2567557176 Reassigns benefits to 1 organization
I20160226000610 OR Practitioner - NeurologyPractitioner - Other (Physician) 2567557176
I20250310001251 MA Practitioner - Sleep Medicine 2567557176 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37156SCMDHome Health Registered Nurse
4301091617MIMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince May 1, 2022 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince May 1, 2022 Accepting new patients
The Regional Medical Center of Orangeburg and Calhoun Counties CurrentSince Aug 25, 2015 Accepting new patients
Sleep Medicine Services of Western Massachusetts LLC CurrentSince Dec 16, 2024 Accepting new patients
The Regional Medical Center of Orangeburg and Calhoun Counties Current Accepting new patients
Sleep Medicine Services of Western Massachusetts LLC Neurology Current Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Neurology CurrentSince Aug 25, 2015 Accepting new patients
Saint Mary'S Health Services Past Accepting new patients
Trinity Health - Michigan Past Accepting new patients

Locations

2 Shircliff Way
Ste 300
Jacksonville, FL 32204
Phone (904) 308-7959

3640 Main St
Ste 208
Springfield, MA 01107
Phone (413) 253-2767

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

Interoperability endpoints

  • Direct secure messaging: jkrainin534484@direct.umm.edu
  • FHIR API: https://fhir-myrecord.cerner.com/r4/0fba742b-eec1-4103-87e5-edbdf1fe1e30/

Organizations & group practices 9

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1386792307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY",
            "address_2": "STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044765",
            "telephone_number": "904-308-7959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258908",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAININ",
        "first_name": "JOSEPH",
        "middle_name": "GORDON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "37156",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD60603804",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "MI",
            "license": "4301091617",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME117836",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "DR.0057012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.