John William Crotty, O.D.
Individual provider Active NPI Corneal and Contact Management Optometrist · Auburn, NE
NPI 1104810795 · NPPES record last updated Dec 3, 2009
Key facts
- NPI
- 1104810795
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Corneal and Contact Management Optometrist 152WC0802X
- License
- 815 (NE)
- Practice address
- 922 Alden Dr
Auburn, NE 68305-3021 - Phone
- (402) 274-3218
- Fax
- (402) 274-4538
- NPI assigned
- Sep 9, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 815 | NE | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | 815 | NE | Yes |
| Pediatric Optometrist | 152WP0200X | 815 | NE |
Addresses
Primary practice location
922 Alden Dr
Auburn, NE 68305-3021
Mailing address
922 Alden Dr
Auburn, NE 68305-3021
Phone (402) 274-3218
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47-0610838 | Other | FEDERAL TAX I.D. | |
| 815 | Other | NE | OPTOMETRY LICENSE |
| MC0048745 | Other | CONTROLLED SUBSTANCE REGI |
Other providers in Auburn, NE
- Barbara Clark
- John Clark
- Julie Clark
- Conrad Dental P.C.
- Katrina Nichole Conrad
- Russell James Crotty
- Ana Medea Damme
- Eldona Samantha Daugherty
- April Noel Dickerson
- Laura Sue Dieckgrafe
All providers in Auburn, NE · Corneal and Contact Management Optometrist in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.