Active NPI
Mary Cronkright, PAC
- Physician Assistant
- Bay City, MI
National Provider Identifier
1467502914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601002954
- Practice address
- 3720 Katalin CT Ste 201
Bay City, MI 48706-2160 - Phone
- (989) 893-9705
- Fax
- (989) 893-8206
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601002954 | MI | Primary |
Addresses
Primary practice location
3720 Katalin CT Ste 201
Bay City, MI 48706-2160
Mailing address
401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-1000
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601002954 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McLaren Flint | Physician Assistant | Past | Accepting new patients |
| McLaren Flint | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physician Assistant
- Flint, MI
- NPI 1700919628
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354838400000",
"number": "1467502914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 S BALLENGER HWY",
"city": "FLINT",
"state": "MI",
"postal_code": "485323638",
"telephone_number": "810-342-1000",
"fax_number": "810-342-1591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3720 KATALIN CT STE 201",
"city": "BAY CITY",
"state": "MI",
"postal_code": "487062160",
"telephone_number": "989-893-9705",
"fax_number": "989-893-8206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRONKRIGHT",
"first_name": "MARY",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2012-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601002954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bay City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.