Individual provider Active NPI

H Randall Craig, M.D.

  • Reproductive Endocrinology Physician
  • Tempe, AZ
National Provider Identifier
1144280249
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
17760 Issued in AZ
Practice address
2155 E Conference Dr
Suite 115
Tempe, AZ 85284-2604
Phone
(480) 831-2445
Fax
(480) 897-1283
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 17760 AZ
General Practice Physician 208D00000X 17760 AZ
Reproductive Endocrinology Physician 207VE0102X 17760 AZ Primary

Addresses

Primary practice location

2155 E Conference Dr
Suite 115
Tempe, AZ 85284-2604

Mailing address

2155 E Conference Dr Ste 115
Tempe, AZ 85284-2604
Phone (480) 831-2445

Other identifiers 1

IdentifierTypeStateIssuer
104597MedicaidAZ

Other names 1

  • H Randall Craig Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050304000077 AZ Practitioner - Peripheral Vascular DiseasePractitioner - Obstetrics/Gynecology 9739133547

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17760AZMDPastoral Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fertility Treatment Center, LLC Reproductive Endocrinology Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1144280249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 E CONFERENCE DR STE 115",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852842604",
            "telephone_number": "480-831-2445",
            "fax_number": "480-897-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 E CONFERENCE DR",
            "address_2": "SUITE 115",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852842604",
            "telephone_number": "480-831-2445",
            "fax_number": "480-897-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "H RANDALL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "17760",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AZ",
            "license": "17760",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "AZ",
            "license": "17760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104597",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "H",
            "last_name": "CRAIG",
            "middle_name": "RANDALL",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.