Active NPI
Stephen Andrew Crandall, MD
- Emergency Medicine Physician
- Corvallis, OR
National Provider Identifier
1497704332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD29279
- Practice address
- 3600 NW Samaritan Dr
Good Samaritan Regional Medical Center
Corvallis, OR 97330-3737 - Phone
- (541) 768-5021
- Fax
- (541) 768-5089
- NPI assigned
- May 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD29279 | OR | Primary |
Addresses
Primary practice location
3600 NW Samaritan Dr
Good Samaritan Regional Medical Center
Corvallis, OR 97330-3737
Mailing address
3600 NW Samaritan Dr
Good Samaritan Regional Medical Center
Corvallis, OR 97330-3737
Phone (541) 768-5021
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD29279 | OR | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392336000000",
"number": "1497704332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 NW SAMARITAN DR",
"address_2": "GOOD SAMARITAN REGIONAL MEDICAL CENTER",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973303737",
"telephone_number": "541-768-5021",
"fax_number": "541-768-5089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 NW SAMARITAN DR",
"address_2": "GOOD SAMARITAN REGIONAL MEDICAL CENTER",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973303737",
"telephone_number": "541-768-5021",
"fax_number": "541-768-5089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANDALL",
"first_name": "STEPHEN",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-08",
"last_updated": "2014-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OR",
"license": "MD29279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.