NPIMap

Individual provider Active NPI

David N Crowther, MD

  • Family Medicine Physician
  • Wautoma, WI
National Provider Identifier
1558465633
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37262 Issued in WI
Practice address
900 E Division St
Wautoma, WI 54982
Phone
(920) 787-6900
NPI assigned
Sep 11, 2006
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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 37262 WI Primary

Addresses

Primary practice location

900 E Division St
Wautoma, WI 54982

Mailing address

900 E Division St
Wautoma, WI 54982-6944
Phone (920) 787-6900

Other practice location 1

2031 Peach St
Wisconsin Rapids, WI 54494-5181
Phone (715) 423-0122

Other identifiers 1

IdentifierTypeStateIssuer
32197200MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dcrowther207940@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051118000352 WI Practitioner - Family Practice 8224028493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

900 E Division St
Wautoma, WI 54982-6944
Phone (920) 303-8700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37262WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Nov 5, 2018 Accepting new patients
Aurora Medical Group, Inc. Family Medicine CurrentSince Nov 5, 2018 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

900 E Division St
Wautoma, WI 54982
Phone (920) 787-0837

Interoperability endpoints

  • Direct secure messaging: dcrowther207940@direct.myadvocateaurora.org

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1558465633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E DIVISION ST",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549826944",
            "telephone_number": "920-787-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E DIVISION ST",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "54982",
            "telephone_number": "920-787-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2031 Peach St",
            "address_purpose": "LOCATION",
            "city": "Wisconsin Rapids",
            "state": "WI",
            "postal_code": "544945181",
            "country_code": "US",
            "telephone_number": "715-423-0122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROWTHER",
        "first_name": "DAVID",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "37262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32197200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dcrowther207940@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "900 E Division St",
            "city": "Wautoma",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "900 E Division St",
            "city": "Wautoma",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wautoma, WI

Sources for this page

Verify at the official NPI Registry.