Gary Stephen Crawford, M.D.
Individual provider Active NPI Family Medicine Physician · Wallace, NC
NPI 1619963121 · NPPES record last updated Jan 14, 2022
Key facts
- NPI
- 1619963121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 9401162 (NC)
- Practice address
- 112 Medical Village Dr
Unit D
Wallace, NC 28466-1668 - Phone
- (910) 285-7592
- Fax
- (910) 285-4610
- NPI assigned
- Sep 21, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Vidant Medical Group LLC
Practice addresses (Care Compare)
125 River Vine Pkwy
Wallace, NC 28466-2377
Phone (910) 285-2134
401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941
401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941
417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080
Hospital & facility affiliations
- Centerwell Home Health
- Well Care Home Health
- Vidant Home Health and Hospice
- Vidant Duplin Hospital
- Novant Health New Hanover Regional Medical Center
- Pender Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.95 of 100
- Quality
- 82.44
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080326000403 | NC | Practitioner - Family Practice | 5496831810 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9401162 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vidant Medical Group LLC | Current |
Accepting new patients |
Locations
2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229
401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941
125 River Vine Pkwy
Wallace, NC 28466
Phone (910) 285-2134
112 Medical Village Dr
Wallace, NC 28466
Phone (910) 285-7388
112 Medical Village Dr
Ste D
Wallace, NC 28466
Phone (910) 285-7592
Interoperability endpoints
- gcrawford14916@direct.vidanthealth.com
- gcrawford14916@direct.ecuhealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9401162 | NC | Yes |
Addresses
Primary practice location
112 Medical Village Dr
Unit D
Wallace, NC 28466-1668
Mailing address
125 River Vine Pkwy
Wallace, NC 28466-2377
Phone (910) 285-2134
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8925388 | Medicaid | NC |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gcrawford14916@direct.vidanthealth.com | Health Information Exchange (HIE) |
Other providers in Wallace, NC
- Coastal Breeze Healthcare
- Coastal Carolina Foot & Ankle Association PA
- Coastline Care Inc
- Community Care Support Services Inc
- Continuum Care Corporation
- Daniel M Ricci M.D. P.a.
- Julianne D Davis
- Anthony Kenneth Defilippis
- Madison Deloney
- Joshua P Denny
All providers in Wallace, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.