NPIMap

Organization Active NPI

William Keith Crummey DMD PC

  • General Practice Dentistry
  • Waycross, GA
National Provider Identifier
1275556409
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10017 Issued in GA
Legal business name
WILLIAM KEITH CRUMMEY DMD PC
Practice address
1601 Alice St
Suite B
Waycross, GA 31501-4532
Phone
(912) 285-5967
Fax
(912) 285-0762
NPI assigned
Jul 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Authorized official

Name
Dr. William Keith Crummey, DMD PCNPI 1598857823
Title
Owner - President of Corp.
Phone
(912) 285-5967

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
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 10017 GA Primary

Addresses

Primary practice location

1601 Alice St
Suite B
Waycross, GA 31501-4532

Mailing address

1601 Alice St
Suite B
Waycross, GA 31501-4532
Phone (912) 285-5967

Other identifiers 1

IdentifierTypeStateIssuer
10017OtherGALIC#

National Provider Directory

National Provider Directory

Locations

1601 Alice St
Ste B
Waycross, GA 31501
Phone (912) 285-5967

Practitioners & affiliated clinicians

Practitioners 3

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": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1275556409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 ALICE ST",
            "address_2": "SUITE B",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014532",
            "telephone_number": "912-285-5967",
            "fax_number": "912-285-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 ALICE ST",
            "address_2": "SUITE B",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014532",
            "telephone_number": "912-285-5967",
            "fax_number": "912-285-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM KEITH CRUMMEY DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "CRUMMEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER - PRESIDENT OF CORP.",
        "authorized_official_telephone_number": "912-285-5967",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD PC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC#",
            "identifier": "10017",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.