Individual provider Active NPI

Lawrence Eugene Crimmins, MD

  • Diagnostic Radiology Physician
  • Ormond Beach, FL
National Provider Identifier
1043279763
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME 61513 Issued in FL
Practice address
1801 John Anderson Dr
Ormond Beach, FL 32176-3206
Phone
(386) 682-2543
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME 61513 FL Primary
Diagnostic Radiology Physician 2085R0202X 33062 GA
General Practice Physician 208D00000X ME 61513 FL
General Practice Physician 208D00000X 33062 GA

Addresses

Primary practice location

1801 John Anderson Dr
Ormond Beach, FL 32176-3206

Mailing address

1801 John Anderson Dr
Ormond Beach, FL 32176-3206
Phone (386) 682-2543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20160408001650 GA Practitioner - Diagnostic Radiology 0345312609 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Georgia School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simonmed Imaging Florida LLCGroup PAC ID 6608036108, 302 clinicians

Practice addresses (Care Compare)

302 Cardinal St
Pooler, GA 31322-1707
Phone (480) 306-6949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 61513FLMDDiagnostic Radiology Physician
33062GAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Physician Group, Inc CurrentSince Feb 1, 2016 Accepting new patients

Locations

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

209 N Cuthbert St
Colquitt, GA 39837
Phone (229) 758-3385

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1043279763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 JOHN ANDERSON DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321763206",
            "telephone_number": "386-682-2543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 JOHN ANDERSON DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321763206",
            "telephone_number": "386-682-2543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIMMINS",
        "first_name": "LAWRENCE",
        "middle_name": "EUGENE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME 61513",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "33062",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME 61513",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "33062",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.