Individual provider Active NPI

Candice Danielle Marilyn Crichlow, M.D.

  • Hospitalist Physician
  • Bismarck, ND
National Provider Identifier
1124383021
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
13515 Issued in ND
Practice address
300 N 7TH St
DWPT of Internal Medicine
Bismarck, ND 58501-4439
Phone
(701) 323-6000
NPI assigned
Jul 7, 2012
Last updated
Mar 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 13515 ND Primary
Internal Medicine Physician 207R00000X 13515 ND

Addresses

Primary practice location

300 N 7TH St
DWPT of Internal Medicine
Bismarck, ND 58501-4439

Mailing address

300 N 7TH St
DWPT of Internal Medicine
Bismarck, ND 58501-4439
Phone (701) 323-6000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150821013777 ND Practitioner - Internal Medicine 0446565253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vibra Physicians LLCGroup PAC ID 8921233933, 30 clinicians

Practice addresses (Care Compare)

1000 18TH St NW
2ND and 3Rd Floors
Mandan, ND 58554-1612
Phone (701) 667-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.63 of 100Reported as group
Quality
89.39
Promoting interoperability
100
Improvement activities
40
Cost
76.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13515NDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Jul 4, 2015 Accepting new patients
Vibra Physicians LLC Hospitalist CurrentSince Jul 26, 2022 Accepting new patients
Vibra Hospital of Central Dakotas LLC Past Accepting new patients

Locations

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

300 N 7th St
Bismarck, ND 58501
Phone (701) 323-6153

1000 18th St NW
#2
Mandan, ND 58554
Phone (701) 667-2000

1000 18th St NW
Mandan, ND 58554
Phone (701) 667-2000

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1341619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1124383021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N 7TH ST",
            "address_2": "DWPT OF INTERNAL MEDICINE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014439",
            "telephone_number": "701-323-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 7TH ST",
            "address_2": "DWPT OF INTERNAL MEDICINE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014439",
            "telephone_number": "701-323-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRICHLOW",
        "first_name": "CANDICE",
        "middle_name": "DANIELLE MARILYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-07",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ND",
            "license": "13515",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "13515",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.