Individual provider Active NPI

Kelsey Crawford, MPAS, PA-C

  • Medical Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1740799295
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
2100 Raybrook St SE Ste 100
Grand Rapids, MI 49546-5782
Phone
(616) 235-5101
NPI assigned
Sep 27, 2017
Last updated
Mar 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

2100 Raybrook St SE Ste 100
Grand Rapids, MI 49546-5782

Mailing address

2100 Raybrook St SE Ste 100
Grand Rapids, MI 49546-5782
Phone (616) 235-5101

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180403002919 MI Practitioner - Physician Assistant 4981967973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faith HospiceGroup PAC ID 9436102845, 9 clinicians

Practice addresses (Care Compare)

2100 Raybrook St SE
Suite 100
Grand Rapids, MI 49546-5782
Phone (616) 235-5101

2100 Raybrook St SE
Suite 300
Grand Rapids, MI 49546-5783

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Palliative Care CurrentSince Nov 4, 2022 Accepting new patients

Locations

8214 Pfeiffer Farms Dr SW
Byron Center, MI 49315
Phone (616) 235-5100

2100 Raybrook St SE
Ste 10
Grand Rapids, MI 49546
Phone (616) 235-5101

2100 Raybrook St SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 235-5101

2100 Raybrook St SE
Ste 300
Grand Rapids, MI 49546
Phone (616) 235-5100

Interoperability endpoints

  • Direct secure messaging: kelsey.crawford.1@16329.direct.athenahealth.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1740799295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 RAYBROOK ST SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465782",
            "telephone_number": "616-235-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 RAYBROOK ST SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465782",
            "telephone_number": "616-235-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "KELSEY",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-27",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.