NPIMap

Individual provider Active NPI

William Crittenden, MD

  • Family Medicine Physician
  • Conway, AR
National Provider Identifier
1427553882
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E14932 Issued in AR
Practice address
2302 College Ave
Conway, AR 72034-6297
Phone
(501) 329-3831
NPI assigned
Mar 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X E14932 AR Primary

Addresses

Primary practice location

2302 College Ave
Conway, AR 72034-6297

Mailing address

2302 College Ave
Conway, AR 72034-6297
Phone (501) 329-3831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20251027000118 MS Practitioner - Family Practice 0941554083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Gulfport, MS 39501-2460

1340 Broad Ave
Gulfport, MS 39501-2465

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-3152

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E14932ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince Jul 28, 2025 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Jul 28, 2025 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

Organizations & group practices 5

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.

Hospital & facility affiliations 61

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

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1427553882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346297",
            "telephone_number": "501-329-3831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346297",
            "telephone_number": "501-329-3831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRITTENDEN",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E14932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.