Individual provider Active NPI

John Craig

  • Clinical Social Worker
  • Crawfordville, FL
National Provider Identifier
1619336526
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW16632 Issued in FL
Practice address
3295 Crawfordville Hwy
Crawfordville, FL 32327-3150
Phone
(850) 296-1785
Fax
(850) 697-3891
NPI assigned
Feb 19, 2016
Last updated
Nov 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW16632 FL Primary

Addresses

Primary practice location

3295 Crawfordville Hwy
Crawfordville, FL 32327-3150

Mailing address

3295 Crawfordville Hwy
Crawfordville, FL 32327-3150
Phone (850) 296-1785

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201023000521 FL Practitioner - Clinical Social Worker 8628498060 Practice locations: Monticello, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Coastal Rehabilitation and Treatment Services. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: johncraig@tdh.allscriptsdirect.net

Organizations & group practices 2

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": "1455840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1619336526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3295 CRAWFORDVILLE HWY",
            "city": "CRAWFORDVILLE",
            "state": "FL",
            "postal_code": "323273150",
            "telephone_number": "850-296-1785",
            "fax_number": "850-697-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3295 CRAWFORDVILLE HWY",
            "city": "CRAWFORDVILLE",
            "state": "FL",
            "postal_code": "323273150",
            "telephone_number": "850-296-1785",
            "fax_number": "850-697-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-19",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crawfordville, FL

Sources for this page

Verify at the official NPI Registry.