Individual provider Active NPI

Anne Carson Crouch, PA-C

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1154574689
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5623 Issued in GA
Practice address
8880 Abercorn St
Savannah, GA 31406-4508
Phone
(912) 331-4444
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5623 GA Primary

Addresses

Primary practice location

8880 Abercorn St
Savannah, GA 31406-4508

Mailing address

PO Box 116510
Atlanta, GA 30368-6073
Phone (912) 355-6615

Other practice location 1

2 Ed Moore Ct Ste A
Statesboro, GA 30458-5024
Phone (912) 231-4444

Other practice location 2

4425 Paulsen St
Savannah, GA 31405-3662
Phone (912) 355-6615

Other practice location 3

459 Hwy 119 S
Springfield, GA 31329-3021
Phone (912) 231-4444

Other identifiers 2

IdentifierTypeStateIssuer
003114220BMedicaidGA
P00727253OtherSCRAILROAD MEDICARE ID-RSFPN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5623GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Optim Orthopedics, LLC PastSince Oct 6, 2019 Accepting new patients
Optim Orthopedics, LLC Past Accepting new patients
Tattnall Hospital Company, LLC PastSince Mar 1, 2016 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1154574689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 116510",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303686073",
            "telephone_number": "912-355-6615",
            "fax_number": "912-351-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 ABERCORN ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064508",
            "telephone_number": "912-331-4444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Ed Moore Ct Ste A",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304585024",
            "country_code": "US",
            "telephone_number": "912-231-4444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4425 Paulsen St",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314053662",
            "country_code": "US",
            "telephone_number": "912-355-6615",
            "fax_number": "912-351-0645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "459 Hwy 119 S",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "GA",
            "postal_code": "313293021",
            "country_code": "US",
            "telephone_number": "912-231-4444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "ANNE",
        "middle_name": "CARSON",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "5623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003114220B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID-RSFPN",
            "identifier": "P00727253",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.