Individual provider Active NPI

Paul Walter Crowl, PA

  • Medical Physician Assistant
  • Anadarko, OK
National Provider Identifier
1104867514
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1006 Issued in OK
Practice address
1002 E Central Blvd
Anadarko, OK 73005-4405
Phone
(405) 247-2551
Fax
(405) 247-8258
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1006 OK Primary

Addresses

Primary practice location

1002 E Central Blvd
Anadarko, OK 73005-4405

Mailing address

1002 E Central Blvd
Anadarko, OK 73005-4405
Phone (405) 247-2551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110727000078 OK Practitioner - Physician Assistant 6305014911 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1006OKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Wellness Anadarko Inc CurrentSince Apr 19, 2024 Accepting new patients
Rural Wellness Fairfax Inc CurrentSince Apr 19, 2024 Accepting new patients
Carter Professional Care, Corp Past Accepting new patients

Locations

1002 E Central Blvd
Anadarko, OK 73005
Phone (405) 247-2551

40 Hospital Rd
Fairfax, OK 74637
Phone (918) 642-8827

Dept 960617
Oklahoma City, OK 73196

2308 W Highway 66
Stroud, OK 74079
Phone (918) 968-3571

Interoperability endpoints

  • Direct secure messaging: paulcrowl@rwhanadarko.medalliesdirect.net

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1104867514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 E CENTRAL BLVD",
            "city": "ANADARKO",
            "state": "OK",
            "postal_code": "730054405",
            "telephone_number": "405-247-2551",
            "fax_number": "405-247-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 E CENTRAL BLVD",
            "city": "ANADARKO",
            "state": "OK",
            "postal_code": "730054405",
            "telephone_number": "405-247-2551",
            "fax_number": "405-247-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWL",
        "first_name": "PAUL",
        "middle_name": "WALTER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anadarko, OK

Sources for this page

Verify at the official NPI Registry.