CROUCH FAMILY MEDICINE PC NPI 1609093228

NPI Information

NPI: 1609093228
Provider Name: CROUCH FAMILY MEDICINE PC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 37D1067992

Address:
806 MANVEL AVE
CHANDLER, OK
ZIP 74834
Phone: (405) 258-9955
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CROUCH FAMILY MEDICINE PC is a primary care clinic center in Chandler, OK. CROUCH FAMILY MEDICINE PC NPI is 1609093228. The provider is registered as an organization entity type.

The provider's business location address is:

806 MANVEL AVE
CHANDLER, OK
ZIP 74834-858
Phone: (405) 258-9955
Fax: (405) 258-9930

The provider's authorized official is Robin Lee Crouch .
The authorized official title is Business Manager and has the following contact phone number (405) 258-9955.

The CLIA number assigned to this NPI record is 37D1067992 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/18/2007 and was last updated on 3/4/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	4290	OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1618242	OTHER		COVENTRY HEALTH CARE PROVIDER ID #
2	300522328	OTHER		MEDICARE # FOR CROUCH FAMILY MEDICINE PC
3	300522328	MEDICARE PIN
4	1497890115	OTHER		NPI FOR JASON CROUCH, D.O. (INDIVIDUAL)
5	200116510A	OTHER	OKLAHOMA	MEDICAID # FOR CROUCH FAMILY MEDICINE PC
6	200116520A	OTHER	OKLAHOMA	MEDICAID # FOR JASON CROUCH, D.O.
7	P00465778	OTHER		RAILROAD MEDICARE PT. B PTAN
8	200116520A	MEDICAID	OKLAHOMA
9	1215222666	OTHER		NPI FOR JANENA MILBURN, APRN, CNP, FNP-C
10	1609093228	OTHER		NPI FOR CROUCH FAMILY MEDICINE (ORGANIZATION)
11	4474235	OTHER		CIGNA HEALTHCARE PROVIDER #
12	6147210001	OTHER	OKLAHOMA	PTAN
13	6147210001	MEDICARE NSC
14	DG9878	OTHER		RAILROAD MEDICARE PT. B GROUP NUMBER
15	200116510A	MEDICAID	OKLAHOMA
16	243722101	MEDICARE PIN
17	DG9878	MEDICARE PIN
18	243722101	OTHER		MEDICARE # FOR JASON CROUCH, D.O.
19	9060050	OTHER		AETNA PIN
20	37D1067992	OTHER		CLIA # FOR CROUCH FAMILY MEDICINE LAB (CLIA-WAIVED LAB)
21	6147210001	OTHER		DME PTAN FOR CROUCH FAMILY MEDICINE
22	OKA104243	OTHER		MEDICARE PTAN FOR JANENA MILBURN, APRN, CNP, FNP-C
23	P00465778	MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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