Individual provider Active NPI

Earl Randy Craven, MD

  • Ophthalmology Physician
  • Baltimore, MD
National Provider Identifier
1457354821
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D75377 Issued in MD
Practice address
600 N Wolfe St
Baltimore, MD 21287-0005
Phone
(410) 955-5000
NPI assigned
May 31, 2005
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D75377 MD Primary

Addresses

Primary practice location

600 N Wolfe St
Baltimore, MD 21287-0005

Mailing address

9910 Franklin Square Dr Ste 2110
Baltimore, MD 21236-4902
Phone (410) 955-5000

Other practice location 1

11960 Lioness Way
Suite 190
Parker, CO 80134-5640
Phone (303) 797-1900

Other practice location 2

11960 Lioness Way
Suite 190
Parker, CO 80134-5640
Phone (303) 797-1900

Other identifiers 1

IdentifierTypeStateIssuer
067071500MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130618000089 MD Practitioner - Ophthalmology 7911811666 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D75377MDMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Ophthalmology CurrentSince Apr 23, 2013 Accepting new patients
Johns Hopkins University Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Associated Eye Care Professionals, PC Ophthalmology PastSince Mar 22, 2004 Accepting new patients

Locations

600 N Wolfe St
Baltimore, MD 21287

8600 Old Georgetown Rd
Bethesda, MD 20814
Phone (301) 896-2578

10751 Falls Rd
Timonium, MD 21093
Phone (410) 583-2727

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1457354821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 FRANKLIN SQUARE DR STE 2110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364902",
            "telephone_number": "410-955-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11960 Lioness Way",
            "address_2": "Suite 190",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801345640",
            "country_code": "US",
            "telephone_number": "303-797-1900",
            "fax_number": "303-347-1341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11960 Lioness Way",
            "address_2": "Suite 190",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801345640",
            "country_code": "US",
            "telephone_number": "303-797-1900",
            "fax_number": "303-347-1341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAVEN",
        "first_name": "EARL",
        "middle_name": "RANDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D75377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067071500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.