Crescent Medical Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD0000028245 Issued in TN

Legal business name

CRESCENT MEDICAL INC.

Practice address

1264 Wesley Dr
Suite 501
Memphis, TN 38116

Phone

(901) 346-1800

Fax

(901) 346-0043

NPI assigned

Aug 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ahsan H Kathawala, M.D.NPI 1962453225

Title

President

Phone

(901) 346-1800

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in TN, MS2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ahsan H Kathawala, M.D.

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1962453225

  MS

  Medicare reassignment NPD Authorized official
• Arifa Kathawala, M.D.

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1396760617
  Medicare reassignment
• Phyllis R Crump, NP

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1760737415
  NPD (past)
• Charlotte R Drake, FNP

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1548580509
  NPD (past)
• Susan B Ibrahim, CRFNP

  • Family Nurse Practitioner
  • Cordova, TN
  • NPI 1568511491
  NPD (past)
• Lashaunda Rogers, APN

  • Primary Care Nurse Practitioner
  • Memphis, TN
  • NPI 1275009037
  NPD (past)

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1295926590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 WESLEY DR",
            "address_2": "SUITE 501",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38116",
            "telephone_number": "901-346-1800",
            "fax_number": "901-346-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 WESLEY DR",
            "address_2": "SUITE 501",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38116",
            "telephone_number": "901-346-1800",
            "fax_number": "901-346-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT MEDICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "KATHAWALA",
        "authorized_official_first_name": "AHSAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-346-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000028245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON HEALTH PLAN",
            "identifier": "000000115782",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEMPHIS MANAGED CARE",
            "identifier": "5009811",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110235971",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3027560",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS",
            "identifier": "607266900",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140096001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "4028944",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8394237",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3804749",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anetha Chantel Crenshaw, P.T., PHARM.D.
• Brent Crenshaw, PHARM D
• Lisa Crenshaw, FNP
• Mallory Crenshaw
• Thomas H Crenshaw, MD
• Cresthaven Internal Medicine Associates
• Crestwyn Health Group, LLC (Crestwyn Behavioral Health)
• Crestwyn Health Group, LLC (Crestwyn Behavioral Health)
• Jill Ann Crews, MS,CCC-SLP
• Tanya Crigler, COTA

• Internal Medicine Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.