Individual provider Active NPI

Elizabeth Mary Crandall, OTR/L

  • Occupational Therapist
  • Charleston, SC
National Provider Identifier
1124135033
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3503 Issued in SC
Practice address
1925 Essex Farms Dr
Charleston, SC 29414-6696
Phone
(843) 779-1685
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3503 SC Primary
Pediatric Occupational Therapist 225XP0200X OT11852 FL

Addresses

Primary practice location

1925 Essex Farms Dr
Charleston, SC 29414-6696

Mailing address

1925 Essex Farms Dr
Charleston, SC 29414-6696
Phone (843) 779-1685

Other identifiers 1

IdentifierTypeStateIssuer
890608400MedicaidFL

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT11852FLMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1124135033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 ESSEX FARMS DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146696",
            "telephone_number": "843-779-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 ESSEX FARMS DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146696",
            "telephone_number": "843-779-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "ELIZABETH",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "3503",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT11852",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890608400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.