Craig T Gillis DO PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

CRAIG T GILLIS DO PC

Practice address

4103 Mercantile Dr
Lake Oswego, OR 97035-2556

Phone

(503) 850-9940

Fax

(503) 850-6709

NPI assigned

Jul 2, 2019

Organization subpart

No

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

Authorized official

Name

Craig Gillis, DONPI 1861755126

Title

Physician

Phone

(503) 850-9940

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Practitioners 1

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

• Craig Thomas Gillis, D.O.

  • Orthopaedic Surgery Physician
  • Lake Oswego, OR
  • NPI 1861755126
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589760000000",
    "number": "1740842467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 MERCANTILE DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352556",
            "telephone_number": "503-850-9940",
            "fax_number": "503-850-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4103 MERCANTILE DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352556",
            "telephone_number": "503-850-9940",
            "fax_number": "503-850-6709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG T GILLIS DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-02",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A",
        "authorized_official_last_name": "GILLIS",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "503-850-9940",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Lynn Cottrell, MA
• Cheryl Ann Couch, LMT
• Johanna Courtleigh, M.A., L.P.C.
• Diana Courtney, RPH
• Shelley Elizabeth Cox, RN
• Alexandra Crain
• Madeline Marie Creagan
• Shayna Crespo, MA
• Criscione Family Dentistry, PC
• Michael J Criscione, D.M.D

• Orthopaedic Surgery Physician in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Orthopaedic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.