Individual provider Active NPI

Benjamin David Crumley, DO

  • Obstetrics & Gynecology Physician
  • Fort Leonard Wood, MO
National Provider Identifier
1043841489
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2504 Issued in NE
Practice address
4234 Illinois Ave
Fort Leonard Wood, MO 65473
Phone
(573) 596-1490
NPI assigned
Feb 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 2504 NE
Obstetrics & Gynecology Physician 207V00000X 2504 NE Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4234 Illinois Ave
Fort Leonard Wood, MO 65473

Mailing address

4234 Illinois Ave
Fort Leonard Wood, MO 65473-9098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20220202002007 NE Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 0941693519

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ach Leonard Wood Past Accepting new patients

Organizations & group practices 1

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": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1043841489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 ILLINOIS AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4234 ILLINOIS AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "65473",
            "telephone_number": "573-596-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMLEY",
        "first_name": "BENJAMIN",
        "middle_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-03",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "2504",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "2504",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Leonard Wood, MO

Sources for this page

Verify at the official NPI Registry.