Individual provider Active NPI

Lydia O. Crane, MD

  • Family Medicine Physician
  • Indialantic, FL
National Provider Identifier
1003806522
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME78798 Issued in FL
Practice address
1220 N Highway A1A
Suite 147
Indialantic, FL 32903-2848
Phone
(321) 984-1333
Fax
(321) 951-9127
NPI assigned
Oct 26, 2005
Last updated
May 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME78798 FL Primary

Addresses

Primary practice location

1220 N Highway A1A
Suite 147
Indialantic, FL 32903-2848

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 984-1333

Other identifiers 1

IdentifierTypeStateIssuer
E4150YOtherFLMEDICARE

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 Medicine

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1003806522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-984-1333",
            "fax_number": "321-951-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 N HIGHWAY A1A",
            "address_2": "SUITE 147",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329032848",
            "telephone_number": "321-984-1333",
            "fax_number": "321-951-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANE",
        "first_name": "LYDIA",
        "middle_name": "O.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME78798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "E4150Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indialantic, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; 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.