Active NPI
Amy Ann Croff, PA-C
- Physician Assistant
- Grand Rapids, MI
National Provider Identifier
1629193487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601003597
- Practice address
- 414 Plymouth Ave NE
Grand Rapids, MI 49505-6038 - Phone
- (616) 454-3465
- Fax
- (616) 454-9004
- NPI assigned
- Mar 20, 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 | 5601003597 | MI | Primary |
Addresses
Primary practice location
414 Plymouth Ave NE
Grand Rapids, MI 49505-6038
Mailing address
414 Plymouth Ave NE
Grand Rapids, MI 49505-6038
Phone (616) 454-3465
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Great Lakes Neurosurgical Associates, PC | Past | Accepting new patients | |
| Medical Observation Services, PLLC | Past | Accepting new patients |
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Maryville, TN
- NPI 1003230236
-
- Family Medicine Physician
- Newport, TN
- NPI 1427005008
-
- Durable Medical Equipment & Medical Supplies
- Grand Rapids, MI
- NPI 1306366810
-
- Emergency Medicine Physician
- Lansing, MI
- NPI 1346503158
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629193487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 PLYMOUTH AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495056038",
"telephone_number": "616-454-3465",
"fax_number": "616-454-9004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 PLYMOUTH AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495056038",
"telephone_number": "616-454-3465",
"fax_number": "616-454-9004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROFF",
"first_name": "AMY",
"middle_name": "ANN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601003597",
"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 Jul 8, 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.