Keith Jensen Criddle, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00016784 Issued in WA

Practice address

202 N Division St
Ste.405, Plaza 2
Auburn, WA 98001-4939

Phone

(253) 939-3604

Fax

(253) 735-4167

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Auburn Family Medical Center, Inc., P.S.

  • General Practice Physician
  • Auburn, WA
  • NPI 1427278001
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1760426191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N DIVISION ST",
            "address_2": "STE.405, PLAZA 2",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980014939",
            "telephone_number": "253-939-3604",
            "fax_number": "253-735-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N DIVISION ST",
            "address_2": "STE.405, PLAZA 2",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980014939",
            "telephone_number": "253-939-3604",
            "fax_number": "253-735-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIDDLE",
        "first_name": "KEITH",
        "middle_name": "JENSEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00016784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "010037194",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8107302",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron Crain
• Brian J Crain, OD
• Marie Crawford, AAC
• Rileigh Crawford
• Allyson Crickenberger
• Rhea Z Crisostomo, MD
• Phyllis E Criss, LPN
• Amanda Kayoko Jennifer Cronkhite, DMD
• Huxley Rian Cross, DC
• Michele Cross, RDH

• Family Medicine Physician in Auburn, WA
• Providers in Auburn, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.