Active NPI
Michael William Crossman, MD
- Pediatrics Physician
- Covington, KY
National Provider Identifier
1659364404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 34515
- Practice address
- 676 Strawberry Hill CT
Covington, KY 41017-9647 - Phone
- (513) 702-3746
- NPI assigned
- Aug 26, 2005
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 34515 | KY | Primary |
Addresses
Primary practice location
676 Strawberry Hill CT
Covington, KY 41017-9647
Mailing address
676 Strawberry Hill CT
Covington, KY 41017-9647
Phone (513) 702-3746
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64961592 | Medicaid | KY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34515 | KY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607040000000",
"number": "1659364404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "676 STRAWBERRY HILL CT",
"city": "COVINGTON",
"state": "KY",
"postal_code": "410179647",
"telephone_number": "513-702-3746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "676 STRAWBERRY HILL CT",
"city": "COVINGTON",
"state": "KY",
"postal_code": "410179647",
"telephone_number": "513-702-3746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROSSMAN",
"first_name": "MICHAEL",
"middle_name": "WILLIAM",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-26",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KY",
"license": "34515",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64961592",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Covington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.