NPIMap

Organization Active NPI

Crawford County Clinic PC

  • Family Medicine Physician
  • Denison, IA
National Provider Identifier
1457305047
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CRAWFORD COUNTY CLINIC PC
Practice address
1820 Highway 30 East
Denison, IA 51442
Phone
(712) 263-6116
Fax
(712) 263-6115
NPI assigned
May 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David M Tancreti, MDNPI 1366435877
Title
President Physician
Phone
(712) 263-6116

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IA
Family Medicine Physician 207Q00000X IA Primary

Addresses

Primary practice location

1820 Highway 30 East
Denison, IA 51442

Mailing address

1820 Highway 30 East
Denison, IA 51442
Phone (712) 263-6116

Other identifiers 1

IdentifierTypeStateIssuer
0222695MedicaidIA

National Provider Directory

National Provider Directory

Locations

1820 Highway 30 E
Denison, IA 51442
Phone (712) 263-6116

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457305047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 HIGHWAY 30 EAST",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "51442",
            "telephone_number": "712-263-6116",
            "fax_number": "712-263-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 HIGHWAY 30 EAST",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "51442",
            "telephone_number": "712-263-6116",
            "fax_number": "712-263-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAWFORD COUNTY CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TANCRETI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT PHYSICIAN",
        "authorized_official_telephone_number": "712-263-6116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0222695",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.