Ryan L Crockett, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1342DT Issued in KY

Practice address

1050 Fording Island Rd
Bluffton, SC 29910-8664

Phone

(843) 227-5530

NPI assigned

Aug 29, 2005

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Crockett Eyes LLC

  • Optometrist
  • Bluffton, SC
  • NPI 1720500127
  Authorized official Same address or phone

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1295728954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 PERCHERON LN",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299263511",
            "telephone_number": "859-585-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 FORDING ISLAND RD",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299108664",
            "telephone_number": "843-227-5530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Sterling Way",
            "address_2": "Ste C",
            "address_purpose": "LOCATION",
            "city": "Mt Sterling",
            "state": "KY",
            "postal_code": "403531174",
            "country_code": "US",
            "telephone_number": "859-498-4800",
            "fax_number": "859-498-2021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "RYAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1342DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77013423",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA",
            "identifier": "000000008636",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000062161",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Cox
• Erica Lowe Coyle, M.S., CCC-SLP
• Margaret Kelly Crapps, MSPT
• Renata Maria Creed, FNP-C
• Crockett Eyes LLC
• Max Croteau, LPC
• Lisa Anne Crouch, MA
• Taylor Anne Crum, OTD, OTR/L
• Rachel Crump, MSW
• Claire Lynn Cuda, PTA

• Optometrist in Bluffton, SC
• Providers in Bluffton, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.