Active NPI
Charles G Crosslin, O.D.
- Corneal and Contact Management Optometrist
- Gassville, AR
National Provider Identifier
1124028493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- 2326
- Practice address
- 7345 Highway 62 W
Gassville, AR 72635 - Phone
- (870) 435-3333
- Fax
- (870) 471-9029
- NPI assigned
- Jul 28, 2005
- Last updated
- Jun 15, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | 2326 | AR | Primary |
Addresses
Primary practice location
7345 Highway 62 W
Gassville, AR 72635
Mailing address
PO Box 444
Mountain Home, AR 72654-0444
Phone (870) 424-4900
Other practice location 1
2943 Highway 62 W
Mountain Home, AR 72653-6535
Phone (870) 424-4900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101232722 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2326 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozark Eye Center, PA | Corneal and Contact Management | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Ophthalmology Physician
- Mountain Home, AR
- NPI 1770624611
Corneal and Contact Management
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529020800000",
"number": "1124028493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 444",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726540444",
"telephone_number": "870-424-4900",
"fax_number": "870-424-4979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7345 HIGHWAY 62 W",
"city": "GASSVILLE",
"state": "AR",
"postal_code": "72635",
"telephone_number": "870-435-3333",
"fax_number": "870-471-9029"
}
],
"practiceLocations": [
{
"address_1": "2943 Highway 62 W",
"address_purpose": "LOCATION",
"city": "Mountain Home",
"state": "AR",
"postal_code": "726536535",
"country_code": "US",
"telephone_number": "870-424-4900",
"fax_number": "870-424-4979",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CROSSLIN",
"first_name": "CHARLES",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-28",
"last_updated": "2018-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "AR",
"license": "2326",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101232722",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gassville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.