Jerome Gavin Craig, DC, LMT

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3896 Issued in OR

Practice address

118 N Killingsworth St
Portland, OR 97217-2435

Phone

(503) 288-4454

Fax

(503) 288-1783

NPI assigned

Nov 17, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Alvis Chiropractic LLCGroup PAC ID 3577736032, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Alvis Chiropractic LLC

  • Chiropractor
  • Portland, OR
  • NPI 1093093320
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232582400000",
    "number": "1952556037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 N KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172435",
            "telephone_number": "503-288-4454",
            "fax_number": "503-288-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 N KILLINGSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172435",
            "telephone_number": "503-288-4454",
            "fax_number": "503-288-1783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "JEROME",
        "middle_name": "GAVIN",
        "credential": "DC, LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-17",
        "last_updated": "2009-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "OR",
            "license": "11637",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Craig-Staffeld, CNIM
• Amber Lane Craig, PCA, QMHP
• Cameron Craig, DPT
• David Harrin Craig, M.D.
• Desiree Rose Craig
• Justine Craig
• Megan Craig, LMFT
• Michelle Craig, BS
• Michelle Dawn Craig, MA, LPC
• Miles Ericson Craig

• Chiropractor in Portland, OR
• Providers in Portland, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.