Active NPI
Kevin Crawford, OD
- Optometrist
- Elizabethtown, KY
National Provider Identifier
1194722819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1097DT
- Practice address
- 1705 N Dixie Hwy
Elizabethtown, KY 42701-5506 - Phone
- (270) 769-2020
- Fax
- (502) 736-4490
- NPI assigned
- Jul 7, 2005
- Last updated
- Jun 14, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1097DT | KY | Primary |
| Optometrist | 152W00000X | 18003162A | IN |
Addresses
Primary practice location
1705 N Dixie Hwy
Elizabethtown, KY 42701-5506
Mailing address
5855 Reliable Pkwy
Chicago, IL 60686-0001
Phone (502) 955-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77010973 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1097 | KY | MD | Health Service Psychologist |
| 18003162A | IN | MD | Optometrist |
| 1097DT | KY | MD | Optometrist |
Interoperability endpoints
- kevincrawford@direct.eyecare-partners.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Louisville, KY
- NPI 1710924949
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276473600000",
"number": "1194722819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5855 RELIABLE PKWY",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606860001",
"telephone_number": "502-955-2020",
"fax_number": "502-736-4490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 N DIXIE HWY",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427015506",
"telephone_number": "270-769-2020",
"fax_number": "502-736-4490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAWFORD",
"first_name": "KEVIN",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2010-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KY",
"license": "1097DT",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18003162A",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "77010973",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elizabethtown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.