NPIMap

Organization Active NPI

Mid-Atlantic Eye Physicians, PA

  • Ophthalmology Physician
  • Roanoke Rapids, NC
National Provider Identifier
1215984331
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MID-ATLANTIC EYE PHYSICIANS, PA
Practice address
204 Becker Dr
Roanoke Rapids, NC 27870-3134
Phone
(252) 537-8193
Fax
(252) 537-0589
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Authorized official

Name
Dr. Brian Crichlow, M.D.NPI 1902986292
Title
President
Phone
(252) 537-8193

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

204 Becker Dr
Roanoke Rapids, NC 27870-3134

Mailing address

204 Becker Dr
Roanoke Rapids, NC 27870-3134
Phone (252) 537-8193

Other identifiers 3

IdentifierTypeStateIssuer
01858OtherNCBCBS OF NC
332641OtherVAANTHEM BCBS
332642OtherVAANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040707001478 VA Part B Supplier - Clinic/Group Practice 4880672815 Receives reassigned benefits from 3 practitioners
Practice locations: South Hill, VA
O20040805000964 NC Part B Supplier - Clinic/Group Practice 4880672815 Receives reassigned benefits from 3 practitioners
Practice locations: Roanoke Rapids, NC
O20150622002045 NC DME Supplier - Physician - Ophthalmology 4880672815 Practice locations: Roanoke Rapids, NC

National Provider Directory

National Provider Directory

Locations

244 Smith Church Rd
Ste C
Roanoke Rapids, NC 27870
Phone (252) 535-2350

204 Becker Dr
Roanoke Rapids, NC 27870
Phone (252) 537-8193

1600 6th Ave
Ste 119B
York, PA 17403
Phone (717) 650-6148

302 N Mecklenburg Ave
South Hill, VA 23970
Phone (252) 537-8193

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605052800000",
    "number": "1215984331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 BECKER DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703134",
            "telephone_number": "252-537-8193",
            "fax_number": "252-537-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 BECKER DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703134",
            "telephone_number": "252-537-8193",
            "fax_number": "252-537-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-ATLANTIC EYE PHYSICIANS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A",
        "authorized_official_last_name": "CRICHLOW",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-537-8193",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "01858",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "332641",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "332642",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke Rapids, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.