Crater Chiropractic Clinic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

272888 Issued in OR

Legal business name

CRATER CHIROPRACTIC CLINIC PC

Practice address

3560 National Rd
Suite 100
Medford, OR 97504-4008

Phone

(541) 734-7333

Fax

(541) 734-8802

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Michael L Warren, DCNPI 1790811511

Title

President

Phone

(541) 734-7333

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael L Warren, DC

  • Chiropractor
  • Medford, OR
  • NPI 1790811511
  Medicare reassignment Care Compare group NPD Authorized official
• Michael M Powell, D.C.

  • Chiropractor
  • Oakridge, OR
  • NPI 1871595298
  Medicare reassignment Care Compare group
• Brenda Jo Moore, LMT

  • Massage Therapist
  • Medford, OR
  • NPI 1184865628
  NPD (past)
• Jeffrey Scott Taylor, D.C.

  • Chiropractor
  • Medford, OR
  • NPI 1013116920
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1710930151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 NATIONAL RD",
            "address_2": "SUITE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044008",
            "telephone_number": "541-734-7333",
            "fax_number": "541-734-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 NATIONAL RD",
            "address_2": "SUITE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044008",
            "telephone_number": "541-734-7333",
            "fax_number": "541-734-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRATER CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-734-7333",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "272888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1790811511",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP",
            "identifier": "1710930151",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Bradley Craft, MD
• Stephanie Marie Cragg, PT, DPT, OCS
• Amanda Marie Cramer
• Kevin Michael Crane, MSW
• Craniosacral Therapy
• Crater Lake Acupuncture LLC
• Crater Lake Acupuncture LLC
• Crater Lake Surgery Center LLC
• Brad Crawford, RN BSN
• Hailey Nicole Crawford, PTA

• Chiropractor in Medford, OR
• Providers in Medford, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.