Devon Craft DO PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

DEVON CRAFT DO PC

Practice address

38 N Main St
Ellenville, NY 12428-1017

Phone

(845) 647-5430

NPI assigned

Mar 16, 2019

Organization subpart

No

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

Authorized official

Name

Devon Craft, DONPI 1831576412

Title

Owner/Physician

Phone

(845) 901-1072

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Craft Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 5

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

• Devon Mark Craft, DO

  • Family Medicine Physician
  • Ellenville, NY
  • NPI 1831576412
  Medicare reassignment NPD Authorized official
• Mark R Craft, DC

  • Chiropractor
  • Ellenville, NY
  • NPI 1679566871
  NPD
• Allise A Marter, DC

  • Chiropractor
  • Ellenville, NY
  • NPI 1235122540
  NPD
• Pericles Christo Gardianos, D.C.

  • Chiropractor
  • Middletown, NY
  • NPI 1770513285
  NPD (past)
• Joseph F Grable, DC

  • Chiropractor
  • New Paltz, NY
  • NPI 1831182138
  NPD (past)

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

{
    "created_epoch": "1552694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552694400000",
    "number": "1871052175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 N MAIN ST",
            "city": "ELLENVILLE",
            "state": "NY",
            "postal_code": "124281017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 N MAIN ST",
            "city": "ELLENVILLE",
            "state": "NY",
            "postal_code": "124281017",
            "telephone_number": "845-647-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVON CRAFT DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-16",
        "last_updated": "2019-03-16",
        "status": "A",
        "authorized_official_last_name": "CRAFT",
        "authorized_official_first_name": "DEVON",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "845-901-1072",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05274704",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Craft Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Craft Chiropractic Associates
• Devon Mark Craft, DO
• Mark R Craft, DC
• Lacy Dalrymple, CASAC
• Damian Family Care Centers, Inc.
• Santiago Diaz
• Mandi Allison Dickman, MSCCC-SLP
• Anthony Dimesa Jr., RN
• Dinovitser Medical PLLC
• Jay Daniel Dinovitser, D.O.

• Primary Care Clinic/Center in Ellenville, NY
• Providers in Ellenville, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2019; 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.