NPIMap

Individual provider Active NPI

Loren Elaine Cragle, PA-C

  • Physician Assistant
  • Greer, SC
National Provider Identifier
1538406491
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2589 Issued in SC
Practice address
420 The Pkwy Ste N
Greer, SC 29650-5205
Phone
(864) 655-4005
NPI assigned
Jan 12, 2013
Last updated
Feb 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003693 OH
Physician Assistant 363A00000X 2589 SC Primary

Addresses

Primary practice location

420 The Pkwy Ste N
Greer, SC 29650-5205

Mailing address

12 Thorncliff CT
Simpsonville, SC 29681-6578
Phone (570) 704-8151

Other practice location 1

4555 Lake Forest Dr
Suite 150
Blue Ash, OH 45242-3785
Phone (513) 281-2278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180326000134 SC Practitioner - Physician Assistant 2668617929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifestyle Neurology LLCGroup PAC ID 6800106469, 4 clinicians

Practice addresses (Care Compare)

52 Bear Dr
Greenville, SC 29605-4458
Phone (864) 655-4005

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2589SCMDOccupational Therapist

Organizations & group practices 1

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 8

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": "1357948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1538406491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 THORNCLIFF CT",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296816578",
            "telephone_number": "570-704-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 THE PKWY STE N",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296505205",
            "telephone_number": "864-655-4005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4555 Lake Forest Dr",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Blue Ash",
            "state": "OH",
            "postal_code": "452423785",
            "country_code": "US",
            "telephone_number": "513-281-2278",
            "fax_number": "513-221-8219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAGLE",
        "first_name": "LOREN",
        "middle_name": "ELAINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-12",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003693",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.