Brian Richard Crouse, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.023470 Issued in OH

Practice address

755 Boardman Canfield Rd
Southbridge West Building L-1
Boardman, OH 44512-4300

Phone

(330) 758-7750

NPI assigned

Sep 7, 2011

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 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1194006965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 BOARDMAN CANFIELD RD",
            "address_2": "SOUTHBRIDGE WEST BUILDING L-1",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124300",
            "telephone_number": "330-758-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 BOARDMAN CANFIELD RD",
            "address_2": "SOUTHBRIDGE WEST BUILDING L-1",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124300",
            "telephone_number": "330-758-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUSE",
        "first_name": "BRIAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-07",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.023470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0064896",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Theodore Cratsley, MD
• Brooke Leigh Crawford, CNP
• Susan C Crawford, ST
• Jessica Crew
• Crossroads Sleep Disorders Center LLC
• Tina Marie Croyle, QMHS
• Francesca Marie Crum, CNP
• Joseph Murphy Crum Sr., D.C.
• Courtney Dawn Cuppett, MD
• Dawn J Curl, LCDCII

• General Practice Dentistry in Boardman, OH
• Providers in Boardman, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.