Kenneth Robert Crawley, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18001737 Issued in IN

Practice address

3501 N Granville Ave Ste L4
Muncie Mall
Muncie, IN 47303-1254

Phone

(765) 286-5977

Fax

(765) 286-5988

NPI assigned

Mar 20, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Luxottica Retail North America Inc

  • Eyewear Supplier
  • Muncie, IN
  • NPI 1447305990
  NPD (past)
• WH Inc

  • Optometrist
  • Muncie, IN
  • NPI 1205805884
  NPD (past)
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1164547048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 N GRANVILLE AVE STE L4",
            "address_2": "MUNCIE MALL",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473031254",
            "telephone_number": "765-286-5977",
            "fax_number": "765-286-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 N GRANVILLE AVE STE L4",
            "address_2": "MUNCIE MALL",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473031254",
            "telephone_number": "765-286-5977",
            "fax_number": "765-286-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWLEY",
        "first_name": "KENNETH",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION BENEFITS OF AMERIC",
            "identifier": "1737",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLARITY",
            "identifier": "43106",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLARITY",
            "identifier": "217779",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000000269589",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUE SHIELD",
            "identifier": "000000269582",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "919893",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "990002951",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "10609",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAI;ROAD MEDICARE",
            "identifier": "P00083065",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "918567",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittney Craig
• John Allen Craig, DDS
• Melanie Dawn Craig, RD
• Shannon Lea Craig, NP
• Amanda Nicole Hartman Craven, EDUCATION SPECIALIST
• Lois Kay Crawley, LSCW
• Donna S Cray, D.C.
• Rylan Isaac Craycraft
• Talon Craycraft
• Kristin Crider, DDS

• Optometrist in Muncie, IN
• Providers in Muncie, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; 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.