Individual provider Active NPI

Jeffrey Brian Craig, M.D.

  • Internal Medicine Physician
  • Owasso, OK
National Provider Identifier
1497982052
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27305 Issued in OK
Practice address
12455 E 100TH St N Ste 350
Owasso, OK 74055-4675
Phone
(918) 274-5510
Fax
(918) 403-6312
NPI assigned
Jun 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 27305 OK Primary

Addresses

Primary practice location

12455 E 100TH St N Ste 350
Owasso, OK 74055-4675

Mailing address

12455 E 100TH St N Ste 350
Owasso, OK 74055-4675
Phone (918) 274-5510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20120724000760 OK Practitioner - Internal Medicine 1951567619 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Physician Group LLCGroup PAC ID 9436122496, 314 clinicians

Practice addresses (Care Compare)

11402 N 135TH E Ave
Owasso, OK 74055-5701
Phone (918) 212-7373

1245 S Utica Ave
Tulsa, OK 74104-4214

20 E 34TH St
Sand Springs, OK 74063-4001
Phone (918) 245-9675

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc. Internal Medicine CurrentSince Aug 8, 2012 Accepting new patients
St. John Physicians, Inc CurrentSince Aug 8, 2012 Accepting new patients
Ahs Oklahoma Physician Group LLC Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Omni Medical Group Inc Internal Medicine CurrentSince Feb 26, 2017 Accepting new patients
Ahs Oklahoma Physician Group, LLC CurrentSince Sep 1, 2019 Accepting new patients

Locations

11402 N 135th East Ave
Owasso, OK 74055
Phone (918) 212-7373

12455 E 100th St N
Ste 350
Owasso, OK 74055
Phone (918) 274-5510

20 E 34th St
Sand Springs, OK 74063
Phone (918) 245-9675

Dept 1206
Tulsa, OK 74182

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

Interoperability endpoints

  • Direct secure messaging: jcraig274013@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1497982052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12455 E 100TH ST N STE 350",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554675",
            "telephone_number": "918-274-5510",
            "fax_number": "918-403-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12455 E 100TH ST N STE 350",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554675",
            "telephone_number": "918-274-5510",
            "fax_number": "918-403-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "JEFFREY",
        "middle_name": "BRIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "27305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

Verify at the official NPI Registry.