Individual provider Active NPI

Rosalynn Yvette Crawford-McKendall, DDS

  • Pediatric Dentistry
  • Pelham, AL
National Provider Identifier
1356597504
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5728 Issued in AL
Practice address
6496 Quail Run Dr
Pelham, AL 35124-3104
Phone
(205) 739-7773
NPI assigned
Aug 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 5728 AL Primary

Addresses

Primary practice location

6496 Quail Run Dr
Pelham, AL 35124-3104

Mailing address

6496 Quail Run Dr
Pelham, AL 35124-3104
Phone (205) 739-7773

Other identifiers 1

IdentifierTypeStateIssuer
154169MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160113002060 AL Order and Referring Only - Other (Non-Physician) 3678875226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5728ALMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Indian Springs Pediatric Dentistry, L.L.C. Pediatric Dentistry 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1356597504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6496 QUAIL RUN DR",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351243104",
            "telephone_number": "205-739-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6496 QUAIL RUN DR",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351243104",
            "telephone_number": "205-739-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD-MCKENDALL",
        "first_name": "ROSALYNN",
        "middle_name": "YVETTE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AL",
            "license": "5728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154169",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, AL

Sources for this page

Verify at the official NPI Registry.