Individual provider Active NPI

Chad David Crim, MD

  • Family Medicine Physician
  • Waco, TX
National Provider Identifier
1508198292
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N4364 Issued in TX
Practice address
1600 Providence Dr
Waco, TX 76707-2261
Phone
(254) 750-8200
Fax
(254) 750-8326
NPI assigned
Feb 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N4364 TX Primary

Addresses

Primary practice location

1600 Providence Dr
Waco, TX 76707-2261

Mailing address

1600 Providence Dr
Waco, TX 76707-2261
Phone (254) 750-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20220721003796 HI Practitioner - Family Practice 5698963056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

4366 Kukui Grove St
Suite 101
Lihue, HI 96766-2006
Phone (808) 246-5600

Hospital & facility affiliations

  • Kaiser Foundation Hospital Hospital, Honolulu, HI, CCN 120011
  • Wilcox Memorial Hospital Hospital, Lihue, HI, CCN 120014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N4364TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Permanente Medical Group Inc CurrentSince Jun 20, 2022 Accepting new patients

Locations

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

4366 Kukui Grove St
Ste 101
Lihue, HI 96766
Phone (808) 246-0051

Organizations & group practices 1

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1508198292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PROVIDENCE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767072261",
            "telephone_number": "254-750-8200",
            "fax_number": "254-750-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PROVIDENCE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767072261",
            "telephone_number": "254-750-8200",
            "fax_number": "254-750-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIM",
        "first_name": "CHAD",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-04",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N4364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.