Individual provider Active NPI

Jordan Sherbrooke Craig, M.D.

  • Obstetrics & Gynecology Physician
  • Grand Rapids, MI
National Provider Identifier
1750515433
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301114306 Issued in MI
Practice address
100 Michigan St NE
Grand Rapids, MI 49503
Phone
(616) 391-2160
Fax
(616) 391-0697
NPI assigned
May 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301114306 MI Primary

Addresses

Primary practice location

100 Michigan St NE
Grand Rapids, MI 49503

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

Other identifiers 1

IdentifierTypeStateIssuer
201096090MedicaidIN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180623000120 MI Practitioner - Obstetrics/Gynecology 3173767167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Indiana University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Rapids Womens Health PCGroup PAC ID 8729162185, 21 clinicians

Practice addresses (Care Compare)

555 Midtown St NE
Suite 400
Grand Rapids, MI 49503-5731
Phone (616) 588-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301114306MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital Obstetrics & Gynecology Current Accepting new patients
Metropolitan Hospital CurrentSince Nov 1, 2022 Accepting new patients
Grand Rapids Womens Health PC Obstetrics & Gynecology CurrentSince May 7, 2024 Accepting new patients

Locations

555 Midtowne St NE
Ste 400
Grand Rapids, MI 49503
Phone (616) 588-1200

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

781 36th St SE
Wyoming, MI 49548
Phone (616) 252-4100

Interoperability endpoints

  • Direct secure messaging: jordan.craig@ogi.gwaydirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1750515433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-391-2160",
            "fax_number": "616-391-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "JORDAN",
        "middle_name": "SHERBROOKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-08",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301114306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201096090",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.