Individual provider Active NPI

Gregory Gordon Stancroff, RPH

  • Pharmacist
  • Grand Rapids, MI
National Provider Identifier
1285826099
Registry record updated Aug 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302026793 Issued in MI
Practice address
2680 Leonard St NE
Grand Rapids, MI 49525-6934
Phone
(616) 224-1121
NPI assigned
Aug 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302026793 MI Primary

Addresses

Primary practice location

2680 Leonard St NE
Grand Rapids, MI 49525-6934

Mailing address

610 Cedar Pines Dr NE
Sparta, MI 49345-8205
Phone (616) 887-6832

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
5302026793MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1285826099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 CEDAR PINES DR NE",
            "city": "SPARTA",
            "state": "MI",
            "postal_code": "493458205",
            "telephone_number": "616-887-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 LEONARD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256934",
            "telephone_number": "616-224-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANCROFF",
        "first_name": "GREGORY",
        "middle_name": "GORDON",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302026793",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 15, 2007; 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.