Individual provider Active NPI

Grace Crawford, MD

  • Internal Medicine Physician
  • Augusta, GA
National Provider Identifier
1174584221
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
060571 Issued in GA
Practice address
1 Freedom Way
Augusta, GA 30904-6258
Phone
(706) 733-0188
Fax
(706) 729-5922
NPI assigned
Mar 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 060571 GA Primary

Addresses

Primary practice location

1 Freedom Way
Augusta, GA 30904-6258

Mailing address

1 Freedom Way
Augusta, GA 30904-6258
Phone (706) 733-0188

Other identifiers 3

IdentifierTypeStateIssuer
02641514MedicaidNY
1174584221MedicaidVA
223858253OtherVATAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160815000899 GA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0840232831

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
060571GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Hospitalists Inc Internal Medicine Past Accepting new patients
Staten Island Physician Practice PC Internal Medicine Past Accepting new patients
Walton Innovations Inc. Past 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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1174584221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "706-733-0188",
            "fax_number": "706-481-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "706-733-0188",
            "fax_number": "706-729-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "GRACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "060571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02641514",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174584221",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "223858253",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.