Active NPI
Craig Newton Norris, DO
- Nephrology Physician
- Clinton TWP, MI
National Provider Identifier
1588669659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 5101008301
- Practice address
- 15520 19 Mile Rd
Ste 480
Clinton TWP, MI 48038-6332 - Phone
- (586) 228-1010
- Fax
- (586) 228-8570
- NPI assigned
- Jun 16, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 5101008301 | MI | Primary |
Addresses
Primary practice location
15520 19 Mile Rd
Ste 480
Clinton TWP, MI 48038-6332
Mailing address
15520 19 Mile Rd
Ste 480
Clinton TWP, MI 48038-6332
Phone (586) 228-1010
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2570048 | Medicaid | MI | |
| 1155000415 | Other | MI | BLUE CROSS/SHIELD IND PIN |
| 4262942 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101118000118 | MI | Practitioner - Nephrology | 4183682289 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101008301 | MI | MD | Nephrology Physician |
Interoperability endpoints
- cnorris63190@direct.hfhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189382400000",
"number": "1588669659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15520 19 MILE RD",
"address_2": "STE 480",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480386332",
"telephone_number": "586-228-1010",
"fax_number": "586-228-8570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15520 19 MILE RD",
"address_2": "STE 480",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480386332",
"telephone_number": "586-228-1010",
"fax_number": "586-228-8570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORRIS",
"first_name": "CRAIG",
"middle_name": "NEWTON",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2007-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MI",
"license": "5101008301",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2570048",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/SHIELD IND PIN",
"identifier": "1155000415",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4262942",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton TWP, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.