Active NPI
Dee Gordon McCrary III, DPM
- Podiatrist
- Greenville, TX
National Provider Identifier
1659699007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 2403
- Practice address
- 4101 Wesley St Ste C
Greenville, TX 75401-5635 - Phone
- (903) 454-8111
- Fax
- (903) 455-8001
- NPI assigned
- May 10, 2010
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 2403 | TX | Primary |
Addresses
Primary practice location
4101 Wesley St Ste C
Greenville, TX 75401-5635
Mailing address
8304 Inspiration LN
McKinney, TX 75071-8599
Phone (903) 454-8111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005479 | Other | TX | BCBS PROVIDER PAR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2403 | TX | MD | Podiatrist |
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.
-
- Medical Specialty Clinic/Center
- Cockeysville, MD
- NPI 1174886642
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583884800000",
"number": "1659699007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8304 INSPIRATION LN",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750718599",
"telephone_number": "903-454-8111",
"fax_number": "903-455-8001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 WESLEY ST STE C",
"city": "GREENVILLE",
"state": "TX",
"postal_code": "754015635",
"telephone_number": "903-454-8111",
"fax_number": "903-455-8001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCRARY",
"first_name": "DEE",
"middle_name": "GORDON",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-10",
"last_updated": "2020-03-11",
"certification_date": "2020-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "TX",
"license": "2403",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER PAR",
"identifier": "005479",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.