Ryan Crouse

Primary specialty

PharmacistTaxonomy code 183500000X

License

051298516 Issued in IL

Practice address

2700 Broadway St
Mount Vernon, IL 62864-2342

Phone

(618) 242-2074

NPI assigned

Nov 17, 2020

Last updated

Nov 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ryan.crouse@cvshealth.com

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.

• Highland Park CVS, L.L.C.

  dba CVS Pharmacy 6370

  • Pharmacy
  • Mount Vernon, IL
  • NPI 1467555235
  NPD (past)

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1144823873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 BROADWAY ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 BROADWAY ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642342",
            "telephone_number": "618-242-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUSE",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051298516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ryan.Crouse@cvshealth.com",
            "affiliation": "N",
            "address_1": "2700 Broadway St",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628642342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Crossroads Physician Corp (Crossroads Family Associates #2)
• Crossroads Physician Corp (Crossroads Family Associates #1)
• Crossroads Physician Corp (Crossroads Internal Medicine #1)
• Crossroads Physician Corp (Crossroads Internal Medicine #2)
• Crossroads Physicians Corp
• Gabrielle Cultice
• Twana Sue Curry, L.C.S.W.
• Danna Kathleen Dailey
• Merenda L Dale, LCSW
• Shirley Dallmier, P.A.

• Pharmacist in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.