NPIMap

Individual provider Active NPI

Laddie Moore Crisp Jr., M.D.

  • Family Medicine Physician
  • Kinston, NC
National Provider Identifier
1295835924
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32676 Issued in NC
Practice address
107 Airport Rd
Kinston, NC 28501-1603
Phone
(252) 527-4146
Fax
(252) 527-5697
NPI assigned
Sep 23, 2006
Last updated
May 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32676 NC Primary

Addresses

Primary practice location

107 Airport Rd
Kinston, NC 28501-1603

Mailing address

2000 Perimeter Park Dr Ste 200
Morrisville, NC 27560-8442

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lcrisp224859@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100728000380 NC Practitioner - Family Practice 1557455367 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

107 Airport Rd
Kinston, NC 28501-1603
Phone (252) 527-4146

2303 Wellington Dr SW
Suite B
Wilson, NC 27893-8620
Phone (252) 243-6818

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32676NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina Hospitals at Chapel Hill Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
University of North Carolina Hospitals at Chapel Hill CurrentSince Jun 1, 2024 Accepting new patients
University of North Carolina Hospitals at Chapel Hill Current Accepting new patients
Lenoir Family Medicine PA Current Accepting new patients
Unc Physicians Network LLC Family Medicine CurrentSince Dec 3, 2018 Accepting new patients
University of North Carolina Hospitals at Chapel Hill Current Accepting new patients
Unc Physicians Network LLC Family Medicine Current Accepting new patients
University of North Carolina Hospitals at Chapel Hill Past Accepting new patients

Locations

100 Sprunt St
Chapel Hill, NC 27517
Phone (919) 843-2164

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

107 Airport Rd
Kinston, NC 28501
Phone (252) 208-2658

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110

Interoperability endpoints

  • Direct secure messaging: laddie-crisp@lenoirfamily.e-mdsdirect.com
  • Direct secure messaging: lcrisp224859@direct.unc.nchie.net

Organizations & group practices 9

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1295835924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR STE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 AIRPORT RD",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285011603",
            "telephone_number": "252-527-4146",
            "fax_number": "252-527-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISP",
        "first_name": "LADDIE",
        "middle_name": "MOORE",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-23",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "32676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lcrisp224859@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "107 Airport Rd",
            "city": "Kinston",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285011603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kinston, NC

Sources for this page

Verify at the official NPI Registry.