Active NPI
Eldon Wayne Crouch, COTA
- Occupational Therapy Assistant
- Butler, AL
National Provider Identifier
1598984080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2716
- Practice address
- 1406 E Pushmataha St
Butler, AL 36904-2728 - Phone
- (205) 459-2394
- NPI assigned
- Apr 24, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 2716 | AL | Primary |
Addresses
Primary practice location
1406 E Pushmataha St
Butler, AL 36904-2728
Mailing address
3331 Summit Blvd
Apt 100
Pensacola, FL 32503-8300
Phone (906) 360-5967
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 |
|---|---|---|---|
| 2716 | AL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598984080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3331 SUMMIT BLVD",
"address_2": "APT 100",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325038300",
"telephone_number": "906-360-5967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1406 E PUSHMATAHA ST",
"city": "BUTLER",
"state": "AL",
"postal_code": "369042728",
"telephone_number": "205-459-2394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROUCH",
"first_name": "ELDON",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AL",
"license": "2716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Butler, AL
- Choctaw County Health Dept Pri Care
- Choctaw County Health Dept STD
- Choctaw County Health Dept VFC Immun
- Choctaw Therapy Services (Tammy L. Turner)
- Cole Chiropractic Clinic
- Rhyann Davis
- Delta Health Group Inc (Willow Trace Nursing Center)
- James Nicholas Donellan
- Freds Stores of Tennessee Inc (Freds Pharmacy 1081)
- Louis Keith Guinn, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.