Active NPI
Keedrick Crapp, DDS
- Dentist
- Fremont, OH
National Provider Identifier
1144715806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30.025877
- Practice address
- 2221 Hayes Ave
Fremont, OH 43420-2632 - Phone
- (419) 334-3869
- NPI assigned
- Jun 26, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 30.025877 | OH | Primary |
Addresses
Primary practice location
2221 Hayes Ave
Fremont, OH 43420-2632
Mailing address
7415 Nightingale Dr Apt 7
Holland, OH 43528-9343
Other practice location 1
502 Van Buren St
Fostoria, OH 44830-1533
Phone (419) 436-7281
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180710001382 | OH | Order and Referring Only - Dentist | 7214283027 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.025877 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1144715806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7415 NIGHTINGALE DR APT 7",
"city": "HOLLAND",
"state": "OH",
"postal_code": "435289343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2221 HAYES AVE",
"city": "FREMONT",
"state": "OH",
"postal_code": "434202632",
"telephone_number": "419-334-3869"
}
],
"practiceLocations": [
{
"address_1": "502 Van Buren St",
"address_purpose": "LOCATION",
"city": "Fostoria",
"state": "OH",
"postal_code": "448301533",
"country_code": "US",
"telephone_number": "419-436-7281",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CRAPP",
"first_name": "KEEDRICK",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-26",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30.025877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.