Individual provider Active NPI

Craig V McBrayer, D.O.

  • Vascular Surgery Physician
  • Muskegon, MI
National Provider Identifier
1881656643
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
08755 Issued in MI
Practice address
1316 Mercy Dr
Muskegon, MI 49444-1835
Phone
(231) 739-9461
Fax
(231) 733-8131
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 08755 MI Primary

Addresses

Primary practice location

1316 Mercy Dr
Muskegon, MI 49444-1835

Mailing address

1316 Mercy Dr
Muskegon, MI 49444-1835
Phone (231) 739-9461

Other identifiers 1

IdentifierTypeStateIssuer
3157281MedicaidMI

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
08755MIMDVascular Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881656643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 MERCY DR",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441835",
            "telephone_number": "231-739-9461",
            "fax_number": "231-733-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 MERCY DR",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441835",
            "telephone_number": "231-739-9461",
            "fax_number": "231-733-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRAYER",
        "first_name": "CRAIG",
        "middle_name": "V",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "08755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3157281",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.