Active NPI
Ethan Thomas Craig
- Social Worker
- Marion, OH
National Provider Identifier
1003350448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.1903694
- Practice address
- 1199 Delaware Ave Ste 107
195 N Grant Ave, Columbus, Oh 43215
Marion, OH 43302 - Phone
- (888) 522-9174
- NPI assigned
- Dec 4, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.1903694 | OH | Primary |
Addresses
Primary practice location
1199 Delaware Ave Ste 107
195 N Grant Ave, Columbus, Oh 43215
Marion, OH 43302
Mailing address
1865 Bealer Dr Apt G
Marion, OH 43302-8764
Phone (740) 361-9098
Other practice location 1
7690 New Market Center Way
Columbus, OH 43235-1976
Phone (614) 602-6473
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003350448 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.1903694 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Haugland, Lamarche, and Ramage LLC | Past | Accepting new patients | |
| Ohioguidestone | Past | Accepting new patients | |
| Haugland Learning Center | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- In Home Supportive Care Agency
- Columbus, OH
- NPI 1265892400
-
- Community/Behavioral Health Agency
- Columbus, OH
- NPI 1346678190
-
- Community/Behavioral Health Agency
- Berea, OH
- NPI 1295096758
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559260800000",
"number": "1003350448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1865 BEALER DR APT G",
"city": "MARION",
"state": "OH",
"postal_code": "433028764",
"telephone_number": "740-361-9098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1199 DELAWARE AVE STE 107",
"address_2": "195 N GRANT AVE, COLUMBUS, OH 43215",
"city": "MARION",
"state": "OH",
"postal_code": "43302",
"telephone_number": "888-522-9174"
}
],
"practiceLocations": [
{
"address_1": "7690 New Market Center Way",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432351976",
"country_code": "US",
"telephone_number": "614-602-6473",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CRAIG",
"first_name": "ETHAN",
"middle_name": "THOMAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-12-04",
"last_updated": "2019-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1903694",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1003350448",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marion, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.