Individual provider Active NPI

Charles Nicolas Crain

  • Diagnostic Radiology Physician
  • Jbsa Lackland, TX
National Provider Identifier
1245623859
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101261010 Issued in VA
Practice address
1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone
(210) 292-6255
NPI assigned
Mar 7, 2015
Last updated
Apr 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101261010 VA Primary

Addresses

Primary practice location

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638

Mailing address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 292-5270

Other practice location 1

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 916-3160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20260227001459 TX Practitioner - Diagnostic Radiology 4587145495 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12554 Riata Vista Cir
Austin, TX 78727-7165

400 W River Woods Pkwy
Glendale, WI 53212-1060

5001 Lyndon B Johnson Fwy
Suite 320
Dallas, TX 75244

5475 Rings Rd
Suite 300
Dublin, OH 43017-3490

5650 Paul Blazer Pkwy
Dublin, OH 43017-3562

7420 Solutions Ctr
Chicago, IL 60677-7004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101261010VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Feb 13, 2026 Accepting new patients
Imaging Associates of Michigan PLLC Diagnostic Radiology CurrentSince May 1, 2026 Accepting new patients
Whasc CurrentSince Aug 10, 2025 Accepting new patients
Empire State Radiology P C Diagnostic Radiology CurrentSince Mar 1, 2026 Accepting new patients
Singleton Associates PA Diagnostic Radiology CurrentSince Mar 1, 2026 Accepting new patients
Imaging Associates of New Mexico LLC Diagnostic Radiology CurrentSince Mar 1, 2026 Accepting new patients
Imaging Associates of Indiana, PC Diagnostic Radiology CurrentSince May 1, 2026 Accepting new patients
Radiology Affiliates of Central New Jersey PC Diagnostic Radiology CurrentSince May 1, 2026 Accepting new patients
Radiology Associates of Southwest Louisiana Diagnostic Radiology PastSince Aug 10, 2025 Accepting new patients
Community Radiology Associates P a Diagnostic Radiology Past Accepting new patients
Synergy Radiology Associates PLLC Past Accepting new patients

Locations

9440 Poppy Dr
Dallas, TX 75218
Phone (214) 324-6100

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

9155 Grapevine Hwy
Ste 120
North Richland Hills, TX 76180

1100 Wilford Hall Loop
Bldg 4554
San Antonio, TX 78236
Phone (210) 292-6225

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1425686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1245623859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-6255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Jbsa Ft Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-3160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAIN",
        "first_name": "CHARLES",
        "middle_name": "NICOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-07",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101261010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Lackland, TX

Sources for this page

Verify at the official NPI Registry.