Individual provider Active NPI

James T. Crowther, D.M.D.

  • General Practice Dentistry
  • Orange City, FL
National Provider Identifier
1265480875
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 009183 Issued in FL
Practice address
272 E Graves Ave
Orange City, FL 32763-5269
Phone
(386) 775-4300
Fax
(386) 775-0630
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 009183 FL Primary

Addresses

Primary practice location

272 E Graves Ave
Orange City, FL 32763-5269

Mailing address

272 E Graves Ave
Orange City, FL 32763-5269
Phone (386) 775-4300

Other identifiers 1

IdentifierTypeStateIssuer
DN9183OtherFLSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160614000023 FL Order and Referring Only - DentistPractitioner - Dentist 3274824784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 009183FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Dentistry, PLLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1265480875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 E GRAVES AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327635269",
            "telephone_number": "386-775-4300",
            "fax_number": "386-775-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 E GRAVES AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327635269",
            "telephone_number": "386-775-4300",
            "fax_number": "386-775-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWTHER",
        "first_name": "JAMES",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 009183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DN9183",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.