Individual provider Active NPI

David Crump, M.D.

  • Surgery Physician
  • Fayetteville, TN
National Provider Identifier
1225118441
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
13246 Issued in MS
Practice address
108 Medical Center Blvd Ste G25
Fayetteville, TN 37334-2741
Phone
(931) 438-7344
NPI assigned
Oct 16, 2006
Last updated
Jan 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 13246 MS Primary

Addresses

Primary practice location

108 Medical Center Blvd Ste G25
Fayetteville, TN 37334-2741

Mailing address

108 Medical Center Blvd
Steg25
Fayetteville, TN 37334-2684
Phone (931) 438-7344

Other identifiers 3

IdentifierTypeStateIssuer
P00205316OtherMSPALMETTO MEDICARE RAILROA
00121751MedicaidMS
C03241OtherMSMEDICARE CAHABA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20181211002053 TN Practitioner - General Surgery 7911958566

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13246MSMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HH Health System - Lincoln Inc CurrentSince Jul 1, 2022 Accepting new patients
HH Health System - Lincoln Inc CurrentSince Jul 1, 2022 Accepting new patients

Locations

106 Medical Center Blvd
Fayetteville, TN 37334
Phone (931) 438-1100

108 Medical Center Blvd
Ste 100
Fayetteville, TN 37334
Phone (931) 433-1102

108 Medical Center Blvd
Ste 125
Fayetteville, TN 37334
Phone (931) 433-3453

108 Medical Center Blvd
Ste 150
Fayetteville, TN 37334
Phone (931) 433-1105

Interoperability endpoints

  • Direct secure messaging: david.crump.1@21536.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/21536/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1225118441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 MEDICAL CENTER BLVD",
            "address_2": "STEG25",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373342684",
            "telephone_number": "931-438-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 MEDICAL CENTER BLVD STE G25",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373342741",
            "telephone_number": "931-438-7344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMP",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "13246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO MEDICARE RAILROA",
            "identifier": "P00205316",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00121751",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CAHABA",
            "identifier": "C03241",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, TN

Sources for this page

Verify at the official NPI Registry.