Individual provider Active NPI

Courtney Margaret Craigan, RN

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1487127676
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201906638NP-PP Issued in OR
Practice address
3303 SW Bond Ave Ste 9
Portland, OR 97239-4501
Phone
(503) 494-7400
Fax
(503) 494-4749
NPI assigned
Jan 10, 2019
Last updated
Nov 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201906638NP-PP OR Primary

Addresses

Primary practice location

3303 SW Bond Ave Ste 9
Portland, OR 97239-4501

Mailing address

3303 SW Bond Ave Ste 9
Portland, OR 97239-4501
Phone (503) 494-7400

Other practice location 1

Kaiser Salmon Creek Medical Office
14406 NE 20th Ave
vancouver, WA 98686
Phone (503) 216-2000

Other practice location 2

Knight Cardiovscular Institute OHSU
3181 SW Sam Jackson Park Rd
Portland, OR 97008
Phone (503) 418-0274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191122001455 OR Practitioner - Nurse Practitioner 2567894983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Columbia Medical CenterGroup PAC ID 3779487251, 99 clinicians

Practice addresses (Care Compare)

1805 E 19TH St
The Dalles, OR 97058-3365
Phone (541) 296-2201

1825 E 19TH St
The Dalles, OR 97058-3365
Phone (541) 296-7811

551 Lone Pine Blvd
The Dalles, OR 97058-9404

PO Box
The Dalles, OR 97058

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
201906638NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Medical Center CurrentSince Sep 1, 2021 Accepting new patients
Healthcare for the Mid-Columbia Region Current Accepting new patients
Mid-Columbia Medical Center CurrentSince Sep 1, 2021 Accepting new patients
Mid-Columbia Medical Center Family Past Accepting new patients

Locations

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

Interoperability endpoints

  • Direct secure messaging: ccraigan135267@direct.ohsu.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1487127676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 SW BOND AVE STE 9",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-7400",
            "fax_number": "503-494-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 SW BOND AVE STE 9",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-7400",
            "fax_number": "503-494-4749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Kaiser Salmon Creek Medical Office",
            "address_2": "14406 NE 20th Ave",
            "address_purpose": "LOCATION",
            "city": "vancouver",
            "state": "WA",
            "postal_code": "98686",
            "country_code": "US",
            "telephone_number": "503-216-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Knight Cardiovscular Institute OHSU",
            "address_2": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97008",
            "country_code": "US",
            "telephone_number": "503-418-0274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAIGAN",
        "first_name": "COURTNEY",
        "middle_name": "MARGARET",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201906638NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.