Jacob Cravens, MD

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

License

32785 Issued in NE

Practice address

4076 Neely Rd
Fort Wainwright, AK 99703

Phone

(907) 361-5172

NPI assigned

Feb 8, 2019

Last updated

Jan 26, 2022By 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

Medicare fee-for-service enrollment

Enrolled in VT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1407311954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 FITZSIMMONS DR",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984311000",
            "telephone_number": "253-968-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 NEELY RD",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703",
            "telephone_number": "907-361-5172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVENS",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-08",
        "last_updated": "2022-01-26",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NE",
            "license": "32785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Coleman
• Taylor L Cone, DDS
• Susan K Connell
• Rebecca P Conner, RN
• Luis A Contreras Zarate, MD
• Tara Michele Crews, MS OTRL
• Amanda Dains, RDH
• Debbie Ann Davis, RN
• Abby Marie Debonis, DDS
• Khanh Dinh, PHARMD

• Military Health Care Provider in Fort Wainwright, AK
• Providers in Fort Wainwright, AK by specialty
• Military Health Care Provider in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.