Active NPI
John Raymond Crump, DMD
- General Practice Dentistry
- Tuscaloosa, AL
National Provider Identifier
1497864581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4626
- Practice address
- 610 Hargrove Rd E
Tuscaloosa, AL 35401-3753 - Phone
- (205) 759-1000
- Fax
- (205) 752-2570
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4626 | AL | Primary |
Addresses
Primary practice location
610 Hargrove Rd E
Tuscaloosa, AL 35401-3753
Mailing address
610 Hargrove Rd E
Tuscaloosa, AL 35401-3753
Phone (205) 759-1000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 529912650 | Medicaid | AL | |
| 92560 | Other | AL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4626 | AL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282003200000",
"number": "1497864581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 HARGROVE RD E",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354013753",
"telephone_number": "205-759-1000",
"fax_number": "205-752-2570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 HARGROVE RD E",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354013753",
"telephone_number": "205-759-1000",
"fax_number": "205-752-2570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUMP",
"first_name": "JOHN",
"middle_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2010-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AL",
"license": "4626",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "529912650",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "92560",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tuscaloosa, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.