Individual provider Active NPI

Audra Maycroft

  • Other Technician
  • Grand Rapids, MI
National Provider Identifier
1972952794
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
2709 Sandstone Ter NE
Grand Rapids, MI 49525-6800
Phone
(616) 206-2868
NPI assigned
Jun 13, 2016
Last updated
Jun 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X NU Primary

Addresses

Primary practice location

2709 Sandstone Ter NE
Grand Rapids, MI 49525-6800

Mailing address

2709 Sandstone Ter NE
Grand Rapids, MI 49525-6800
Phone (616) 206-2868

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1972952794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 SANDSTONE TER NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256800",
            "telephone_number": "616-206-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 SANDSTONE TER NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256800",
            "telephone_number": "616-206-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYCROFT",
        "first_name": "AUDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "NU",
            "license": null,
            "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 Jun 13, 2016; 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.