Individual provider Active NPI

Susan Lawrence Crittenden, MD

  • Internal Medicine Physician
  • Cary, NC
National Provider Identifier
1063553436
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
26434 Issued in NC
Practice address
530 New Waverly PL
Suite 200
Cary, NC 27511-7414
Phone
(919) 859-5955
Fax
(919) 859-5659
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 26434 NC Primary

Addresses

Primary practice location

530 New Waverly PL
Suite 200
Cary, NC 27511-7414

Mailing address

PO Box 18563
Raleigh, NC 27619-8563
Phone (919) 782-1806

Other identifiers 6

IdentifierTypeStateIssuer
110167670OtherRAILROAD MEDICARE
0452674OtherUNITED HEALTHCARE
5121657OtherCIGNA
67051OtherMEDCOST
8925762MedicaidNC
25762OtherNCBCBS

Other names 1

  • Susan Lawrence Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20040817001442 NC Practitioner - Internal Medicine 9234102229

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26434NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Medical Group, PA Internal Medicine CurrentSince Oct 1, 1996 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Rex Hospital, Inc. Past Accepting new patients

Locations

1900 Kildaire Farm Rd
Cary, NC 27518
Phone (919) 350-2300

530 New Waverly Pl
Ste 200
Cary, NC 27518
Phone (919) 859-5955

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

3521 Haworth Dr
Raleigh, NC 27609
Phone (919) 782-1806

Interoperability endpoints

  • Direct secure messaging: susan.crittenden.1@23663.direct.athenahealth.com
  • Direct secure messaging: susan.crittenden.1@15189.direct.athenahealth.com
  • Direct secure messaging: susancrittenden@rcmg.allscriptsdirect.net

Organizations & group practices 3

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1063553436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18563",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276198563",
            "telephone_number": "919-782-1806",
            "fax_number": "919-782-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NEW WAVERLY PL",
            "address_2": "SUITE 200",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275117414",
            "telephone_number": "919-859-5955",
            "fax_number": "919-859-5659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRITTENDEN",
        "first_name": "SUSAN",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "26434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110167670",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0452674",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5121657",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "67051",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8925762",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "25762",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "LAWRENCE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.