Charlene Ann Crandall, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

2666 Issued in AZ

Practice address

Banner MD Anderson Cancer Center
2940 E. Banner Gateway Drive
Gilbert, AZ 85234

Phone

(480) 256-6444

Fax

(480) 256-3682

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charlene.crandall@mfamd-az.direct.office.nextgen.com

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.

• Banner Cancer Center Specialists LLC

  • Oncology Clinic/Center
  • Phoenix, AZ
  • NPI 1518253152
  Medicare reassignment
• Emergency Physicians Southwest, PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1912053752
  Medicare reassignment
• Banner Cancer Center Specialists LLC

  • Oncology Clinic/Center
  • Payson, AZ
  • NPI 1588158448
  NPD
• Apache Junction Urgent Care LLC

  • Urgent Care Clinic/Center
  • Apache Junction, AZ
  • NPI 1053375659
  NPD (past)
• Avondale Urgent Care LLC

  • Urgent Care Clinic/Center
  • Avondale, AZ
  • NPI 1134185671
  NPD (past)
• Casa Grande Urgent Care LLC

  • Urgent Care Clinic/Center
  • Casa Grande, AZ
  • NPI 1265496863
  NPD (past)
• Chandler Urgent Care LLC

  • Urgent Care Clinic/Center
  • Chandler, AZ
  • NPI 1881650471
  NPD (past)
• Dana Landing Urgent Care LLC

  • Urgent Care Clinic/Center
  • Mesa, AZ
  • NPI 1770549214
  NPD (past)
• Deseret Family Practice, LTD.

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1215960638
  NPD (past)
• Desert Ridge Urgent Care LLC

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1861458309
  NPD (past)
• Glendale Urgent Care LLC

  • Urgent Care Clinic/Center
  • Glendale, AZ
  • NPI 1043276587
  NPD (past)
• Greenway Urgent Care LLC

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1629034210
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1124059217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BANNER MD ANDERSON CANCER CENTER",
            "address_2": "2940 E. BANNER GATEWAY DRIVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85234",
            "telephone_number": "480-256-6444",
            "fax_number": "480-256-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BANNER MD ANDERSON CANCER CENTER",
            "address_2": "2940 E. BANNER GATEWAY DRIVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85234",
            "telephone_number": "480-256-6444",
            "fax_number": "480-256-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "CHARLENE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2666",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "2666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig L. Mechelke, D.O., LTD.
• Denise M Craig, WHNP-BC
• Melissa Craig, PA-C
• Tiffany Cramer-Eliason
• Annelise Crandall
• Casey Lane Crandell, M.D.
• Kristine Marie Cranford
• Cranial Technologies, Inc.
• Emily Crann
• Shannon Crawford-West, PMHNP-BC

• Surgical Physician Assistant in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.