Organization Active NPI

Jeffrey T Craig, DC, PC

  • Chiropractor
  • Bend, OR
National Provider Identifier
1952409310
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3218 Issued in OR
Legal business name
JEFFREY T CRAIG, DC, PC
Practice address
875 SE 3Rd St
Suite 102
Bend, OR 97702-1786
Phone
(541) 330-6581
Fax
(541) 330-2326
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Authorized official

Name
Jeffrey Thomas CraigNPI 1518986041
Title
Owner
Phone
(541) 330-6581

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3218 OR Primary

Addresses

Primary practice location

875 SE 3Rd St
Suite 102
Bend, OR 97702-1786

Mailing address

875 SE 3Rd St
Suite 102
Bend, OR 97702-1786
Phone (541) 330-6581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040517000872 OR Part B Supplier - Clinic/Group Practice 2062402423 Receives reassigned benefits from 1 practitioner
Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Locations

1230 NE 3rd St
#102
Bend, OR 97701
Phone (541) 330-6581

875 SE 3rd St
Ste 102
Bend, OR 97702
Phone (541) 330-6581

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1952409310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 SE 3RD ST",
            "address_2": "SUITE 102",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021786",
            "telephone_number": "541-330-6581",
            "fax_number": "541-330-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 SE 3RD ST",
            "address_2": "SUITE 102",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021786",
            "telephone_number": "541-330-6581",
            "fax_number": "541-330-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY T CRAIG, DC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-330-6581"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.