NPIMap

Individual provider Active NPI

Kenneth Joseph Crowe, M.D.

  • Family Medicine Physician
  • Opp, AL
National Provider Identifier
1124169651
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18485 Issued in AL
Practice address
802 N Main St
Suite a
Opp, AL 36467-1614
Phone
(334) 493-2530
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18485 AL Primary

Addresses

Primary practice location

802 N Main St
Suite a
Opp, AL 36467-1614

Mailing address

802 N Main St
Suite a
Opp, AL 36467-1614

Other identifiers 3

IdentifierTypeStateIssuer
000023704MedicaidAL
080155685OtherRAILROAD MEDICARE
51023704OtherALBCBS OF ALABAMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100308000033 AL Practitioner - General Practice 8426012857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mizell Memorial Hospital, Inc. 12 clinicians

Practice addresses (Care Compare)

802 N Main St
Opp, AL 36467-1614
Phone (334) 493-3240

Hospital & facility affiliations

  • Mizell Memorial Hospital Hospital, Opp, AL, CCN 010007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mizell Memorial Hospital, Inc. Current Accepting new patients
Mizell Memorial Hospital, Inc. Family Medicine CurrentSince Apr 2, 2018 Accepting new patients
Mizell Memorial Hospital, Inc. Family Medicine CurrentSince Apr 2, 2018 Accepting new patients
Emcare Physician Providers, Inc. Past Accepting new patients

Locations

802 N Main St
Opp, AL 36467
Phone (334) 493-3240

702 N Main St
Opp, AL 36467
Phone (334) 493-2342

802 N Main St
Ste A
Opp, AL 36467
Phone (334) 493-2530

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mizell Memorial Hospital, Inc.Opp, AL, CCN 01U007 Hospital Corporate Director Jan 1, 2012
Mizell Memorial Hospital, Inc.Opp, AL, CCN 010007 Hospital Corporate Director Jan 1, 2012
Mizell Memorial Hospital, Inc.Opp, AL, CCN 01S007 Hospital Corporate Director Jan 1, 2012

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1124169651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 N MAIN ST",
            "address_2": "SUITE A",
            "city": "OPP",
            "state": "AL",
            "postal_code": "364671614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 N MAIN ST",
            "address_2": "SUITE A",
            "city": "OPP",
            "state": "AL",
            "postal_code": "364671614",
            "telephone_number": "334-493-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWE",
        "first_name": "KENNETH",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "18485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000023704",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080155685",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "51023704",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Opp, AL

Sources for this page

Verify at the official NPI Registry.