Organization Active NPI

Joshua Crowder, O.D. PC

  • Optometrist
  • Chattanooga, TN
National Provider Identifier
1114222148
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2816 Issued in TN
Legal business name
JOSHUA CROWDER, O.D. PC
Practice address
7329 Shallowford Rd
Chattanooga, TN 37421-2627
Phone
(423) 899-2020
Fax
(423) 899-3388
NPI assigned
Jan 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Authorized official

Name
Dr. Joshua Eric Crowder, O.D.NPI 1346405420
Title
President
Phone
(423) 899-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2816 TN Primary

Addresses

Primary practice location

7329 Shallowford Rd
Chattanooga, TN 37421-2627

Mailing address

7329 Shallowford Rd
Chattanooga, TN 37421-2627
Phone (423) 899-2020

Other identifiers 1

IdentifierTypeStateIssuer
103G416812MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110616000342 TN Part B Supplier - Clinic/Group Practice 4082891270 Receives reassigned benefits from 4 practitioners
Practice locations: Chattanooga, TN

National Provider Directory

National Provider Directory

Locations

7329 Shallowford Rd
Chattanooga, TN 37421
Phone (423) 314-2000

726 Highway 72
South Pittsburg, TN 37380
Phone (423) 837-2020

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1295740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1114222148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7329 SHALLOWFORD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212627",
            "telephone_number": "423-899-2020",
            "fax_number": "423-899-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7329 SHALLOWFORD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212627",
            "telephone_number": "423-899-2020",
            "fax_number": "423-899-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSHUA CROWDER, O.D. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-23",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "CROWDER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-899-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103G416812",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.