Individual provider Active NPI

Bradley Robert Craig, M.D.

  • Emergency Medicine Physician
  • Omak, WA
National Provider Identifier
1790737310
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00025051 Issued in WA
Practice address
810 Jasmine St
Omak, WA 98841-9578
Phone
(509) 826-1760
Fax
(509) 826-7211
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD00025051 WA Primary

Addresses

Primary practice location

810 Jasmine St
Omak, WA 98841-9578

Mailing address

PO Box 793
Omak, WA 98841-0793
Phone (509) 826-1760

Other identifiers 1

IdentifierTypeStateIssuer
254327OtherWAL&I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00025051WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chelan County Public Hospital District No 2 CurrentSince Apr 25, 2018 Accepting new patients
Chelan County Public Hospital District No 2 CurrentSince Apr 25, 2018 Accepting new patients
Washington Em-I Medical Services PC Emergency Medicine Past Accepting new patients
Okanogan Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

110 S Apple Blossom Dr
Chelan, WA 98816
Phone (509) 682-3300

503 E Highland Ave
Chelan, WA 98816
Phone (509) 682-3300

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1790737310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 793",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988410793",
            "telephone_number": "509-826-1760",
            "fax_number": "509-826-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 JASMINE ST",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419578",
            "telephone_number": "509-826-1760",
            "fax_number": "509-826-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "BRADLEY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00025051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "254327",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omak, WA

Sources for this page

Verify at the official NPI Registry.