Active NPI
Mary Thelma Crowder, MD
- Gynecology Physician
- Charlotte, NC
National Provider Identifier
1184835753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 38752
- Practice address
- 423 S Sharon Amity Rd Ste C
Charlotte, NC 28211-2974 - Phone
- (704) 333-4817
- Fax
- (704) 333-4879
- NPI assigned
- May 25, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 38752 | NC | Primary |
Addresses
Primary practice location
423 S Sharon Amity Rd Ste C
Charlotte, NC 28211-2974
Mailing address
423 S Sharon Amity Rd Ste C
Charlotte, NC 28211-2974
Phone (704) 333-4817
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 22, 2015 through Dec 22, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38752 | NC | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1184835753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "423 S SHARON AMITY RD STE C",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282112974",
"telephone_number": "704-333-4817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "423 S SHARON AMITY RD STE C",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282112974",
"telephone_number": "704-333-4817",
"fax_number": "704-333-4879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROWDER",
"first_name": "MARY",
"middle_name": "THELMA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-25",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "NC",
"license": "38752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.