Mark Alden Crislip, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

MD16614 Issued in OR

Practice address

1015 NW 22ND
R200
Portland, OR 97210

Phone

(503) 413-8258

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mark a Crislip

  • Infectious Disease Physician
  • Portland, OR
  • NPI 1013129410
  NPD (past) Authorized official
• Legacy Clinics LLC

  dba Legacy Medical Group Firwood

  • Rural Health Clinic/Center
  • Sandy, OR
  • NPI 1730472192
  NPD (past)
• Raymond Bracis, MD

  • Infectious Disease Physician
  • Portland, OR
  • NPI 1174745418
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457461022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10347 SE 99TH DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972667230",
            "telephone_number": "503-774-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 NW 22ND",
            "address_2": "R200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "503-413-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISLIP",
        "first_name": "MARK",
        "middle_name": "ALDEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OR",
            "license": "MD16614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Crino, M.S., CCC-SLP
• Robert John Crippen, CADC 1
• Daniela Crisan, PHARMD
• Delphine Criscenzo
• Nicole Jeanine Crise
• Angela Kelly Crisman, MA
• Sonja Charlene Crisosto, LCSW
• Kara Crisp, N.D.
• Kathy Ann Crispell, MD
• Julie A Crispin, L.M.T.

• Infectious Disease Physician in Portland, OR
• Providers in Portland, OR by specialty
• Infectious Disease Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.