Individual provider Active NPI

John Andrew Crenshaw, MD

  • Otolaryngology Physician
  • Winston Salem, NC
National Provider Identifier
1194213876
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
2023-00818 Issued in NC
Practice address
110 Charlois Blvd
Winston Salem, NC 27103-1522
Phone
(336) 768-3361
Fax
(336) 659-2446
NPI assigned
Apr 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 2023-00818 NC Primary

Addresses

Primary practice location

110 Charlois Blvd
Winston Salem, NC 27103-1522

Mailing address

110 Charlois Blvd
Winston Salem, NC 27103-1522
Phone (336) 768-3361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230613000534 NC Practitioner - Otolaryngology 7810242740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of North Carolina at Chapel Hill School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlotte Eye Ear Nose and Throat Associates PAGroup PAC ID 0446155451, shared by 3 NPIs, 181 clinicians
Piedmont Ear, Nose and Throat Associates, P.a.Group PAC ID 4486617032, 28 clinicians

Practice addresses (Care Compare)

110 Charlois Blvd
Winston Salem, NC 27103-1522
Phone (336) 768-3361

Hospital & facility affiliations

  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014
  • Novant Health Medical Park Hospital Hospital, Winston-Salem, NC, CCN 340148
  • Hugh Chatham Memorial Hospital Hospital, Elkin, NC, CCN 340097

Merit-based Incentive Payment System (MIPS)

Final score
74.6 of 100Reported as group
Quality
31.13
Promoting interoperability
99
Improvement activities
40
Cost
85.04

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Ear, Nose & Throat Associates, P.a. Otolaryngology CurrentSince Aug 1, 2023 Accepting new patients
Charlotte Eye Ear Nose & Throat Associates, P.a. Otolaryngology PastSince Aug 1, 2023 Accepting new patients

Locations

110 Charlois Blvd
Winston Salem, NC 27103
Phone (336) 768-3361

Interoperability endpoints

  • Direct secure messaging: jcrenshaw169520@directhisp.wakemed.org
  • Direct secure messaging: johncrenshaw@penta.allscriptsdirect.net
  • Direct secure messaging: jcrenshaw1139783@direct.novanthealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1194213876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031522",
            "telephone_number": "336-768-3361",
            "fax_number": "336-659-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031522",
            "telephone_number": "336-768-3361",
            "fax_number": "336-659-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRENSHAW",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-27",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "2023-00818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.