Organization Active NPI

Michael J Crawford MD PC

  • Ophthalmology Physician
  • Grand Rapids, MI
National Provider Identifier
1154515369
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301034057 Issued in MI
Legal business name
MICHAEL J CRAWFORD MD PC
Practice address
415 College Ave NE
Grand Rapids, MI 49503-1705
Phone
(616) 458-4205
Fax
(616) 459-3001
NPI assigned
Aug 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Authorized official

Name
Dr. Michael J Crawford, MD
Title
President
Phone
(616) 458-4205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 4301034057 MI Primary

Addresses

Primary practice location

415 College Ave NE
Grand Rapids, MI 49503-1705

Mailing address

415 College Ave NE
Grand Rapids, MI 49503-1705
Phone (616) 458-4205

Other identifiers 1

IdentifierTypeStateIssuer
1498399MedicaidMI

National Provider Directory

National Provider Directory

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": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1154515369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 COLLEGE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031705",
            "telephone_number": "616-458-4205",
            "fax_number": "616-459-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 COLLEGE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031705",
            "telephone_number": "616-458-4205",
            "fax_number": "616-459-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J CRAWFORD MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-458-4205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301034057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1498399",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.