Willie Craft Jr., M.D., PH.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35.125076 Issued in OH

Practice address

3130 N County Road 25a
Troy, OH 45373-1337

Phone

(937) 440-4466

Fax

(937) 440-4470

NPI assigned

Jul 1, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Upper Valley Professional Corporation

  • Family Medicine Physician
  • Troy, OH
  • NPI 1407872518

  Internal Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1992092696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 N COUNTY ROAD 25A",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731337",
            "telephone_number": "937-440-4466",
            "fax_number": "937-440-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 N COUNTY ROAD 25A",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731337",
            "telephone_number": "937-440-4466",
            "fax_number": "937-440-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAFT",
        "first_name": "WILLIE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT319199",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.125076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0112213",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "wcraft691850@direct.premierhealth.com",
            "affiliation": "N",
            "address_1": "3130 N County Road 25A",
            "city": "Troy",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453731337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert B Cost, CDCA
• Megan Jeanne Cotner
• Kathleen Cottrell, LPN
• Melissa Courts, BS, IBCLC
• Amanda B Crabtree, LISW
• Stephen Crane
• Ronald K Craycraft, RPH
• Kelly Crego-Lee, RN APRN
• Judith Lynn Crim, PTA
• Craig Critchley, DO

• Internal Medicine Physician in Troy, OH
• Providers in Troy, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.

Verify at the official NPI Registry.