Charles Allen Crouch, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

28570 Issued in IA

Practice address

1200 1St Ave E
Suite C
Spencer, IA 51301-4342

Phone

(712) 262-7511

Fax

(712) 262-3658

NPI assigned

May 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Davis Radiology, P.C.

  • Diagnostic Radiology Physician
  • Mt Pleasant, IA
  • NPI 1538129721

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1477556280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 1ST AVE E",
            "address_2": "SUITE C",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014342",
            "telephone_number": "712-262-7511",
            "fax_number": "712-262-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 1ST AVE E",
            "address_2": "SUITE C",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014342",
            "telephone_number": "712-262-7511",
            "fax_number": "712-262-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "CHARLES",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "28570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5118760",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Health Center of Fort Dodge, Inc.
• Compass Pointe, Behavioral Health Services
• Molly Conlon, PHARMD.
• Brenda Coulander, CADC
• Ronald James Creswell, M.D.
• Crown Clinics LLC
• Robert Alexander Cunningham Jr., ATC/L
• Jessica E Curran, O.D.
• Amy R Davis
• Benjamin Robert Davis, ATC

• All providers in Spencer, IA
• Diagnostic Radiology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.