Individual provider Active NPI

Jordan W Crafton, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Tucson, AZ
National Provider Identifier
1861840274
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD-000970 Issued in AZ
Practice address
630 N Alvernon Way Ste 351
Tucson, AZ 85711-1838
Phone
(520) 881-2600
Fax
(520) 881-2600
NPI assigned
May 25, 2016
Last updated
Jul 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X POD-000970 AZ Primary

Addresses

Primary practice location

630 N Alvernon Way Ste 351
Tucson, AZ 85711-1838

Mailing address

PO Box 13627
Tucson, AZ 85732-3627
Phone (520) 881-2600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230124002539 ID Practitioner - Podiatry 7618390527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Western Un of HLTH Sciences, Col of Podiatric Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madison Co Memorial HospitalGroup PAC ID 8123016367, 34 clinicians

Practice addresses (Care Compare)

25 Madison Professional Park
Rexburg, ID 83440-2057
Phone (208) 359-1400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue27
Removal of skin lesions1-10
Removal of nail tissue14
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Co Memorial Hospital Current Accepting new patients
Madison Co Memorial Hospital Podiatrist CurrentSince Oct 1, 2022 Accepting new patients
Valley ENT, PC Past Accepting new patients
Madison Co Memorial Hospital Podiatrist Past Accepting new patients

Locations

25 Madison Professional Park
Rexburg, ID 83440
Phone (208) 359-1400

37 S 2nd E
Rexburg, ID 83440
Phone (208) 356-0234

393 E 2nd N
Rexburg, ID 83440
Phone (208) 356-5401

450 E Main St
Rexburg, ID 83440
Phone (208) 356-3691

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1861840274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13627",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857323627",
            "telephone_number": "520-881-2600",
            "fax_number": "520-881-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N ALVERNON WAY STE 351",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111838",
            "telephone_number": "520-881-2600",
            "fax_number": "520-881-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAFTON",
        "first_name": "JORDAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-25",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "POD-000970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.