Individual provider Active NPI

Jason Davis McCraw, D.C.

  • Chiropractor
  • Clearlake, CA
National Provider Identifier
1568904969
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
33926 Issued in CA
Practice address
15230 Lakeshore Dr
Clearlake, CA 95422-8107
Phone
(707) 995-4500
Fax
(707) 994-9456
NPI assigned
Nov 16, 2016
Last updated
Mar 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-1745 ID
Chiropractor 111N00000X 33926 CA Primary

Addresses

Primary practice location

15230 Lakeshore Dr
Clearlake, CA 95422-8107

Mailing address

15230 Lakeshore Dr
Clearlake, CA 95422-8107
Phone (707) 995-4500

Other identifiers 1

IdentifierTypeStateIssuer
271532466OtherGROUP NPI 1477811750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200115001379 CA Practitioner - Chiropractic 3375824782 Reassigns benefits to 1 organization
Practice locations: Auburn, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Western Sierra Medical Clinic, Inc. CurrentSince Nov 27, 2023 Accepting new patients
Western Sierra Medical Clinic, Inc. CurrentSince Nov 27, 2023 Accepting new patients
Western Sierra Medical Clinic, Inc. Past Accepting new patients

Locations

1345 Whispering Pines Ln
Grass Valley, CA 95945
Phone (530) 265-7895

844 Old Tunnel Rd
Grass Valley, CA 95945
Phone (530) 273-4984

Interoperability endpoints

  • Direct secure messaging: jason.mccraw@wsmc1.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1568904969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15230 LAKESHORE DR",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954228107",
            "telephone_number": "707-995-4500",
            "fax_number": "707-994-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15230 LAKESHORE DR",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954228107",
            "telephone_number": "707-995-4500",
            "fax_number": "707-994-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRAW",
        "first_name": "JASON",
        "middle_name": "DAVIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-16",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1745",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI 1477811750",
            "identifier": "271532466",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearlake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.