Individual provider Active NPI

Michael Ellis Craycraft, R.PH.

  • Pharmacist
  • Cincinnati, OH
National Provider Identifier
1053656835
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03221310 Issued in OH
Practice address
792 Woodlyn Dr S
Cincinnati, OH 45230-4323
Phone
(561) 703-1788
NPI assigned
Dec 4, 2012
Last updated
Dec 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03221310 OH Primary
Pharmacist 183500000X PS 33409 FL

Addresses

Primary practice location

792 Woodlyn Dr S
Cincinnati, OH 45230-4323

Mailing address

792 Woodlyn Dr S
Cincinnati, OH 45230-4323
Phone (561) 703-1788

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS 33409FLMDPharmacist
03221310OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1053656835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 WOODLYN DR S",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452304323",
            "telephone_number": "561-703-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 WOODLYN DR S",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452304323",
            "telephone_number": "561-703-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAYCRAFT",
        "first_name": "MICHAEL",
        "middle_name": "ELLIS",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-04",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03221310",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS 33409",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.