Individual provider Active NPI

Dee Gordon McCrary III, DPM

  • Podiatrist
  • Greenville, TX
National Provider Identifier
1659699007
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
2403 Issued in TX
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

Updated by the provider on Mar 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
005479OtherTXBCBS 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120629000252 MD Practitioner - Podiatry 6709041536 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2403TXMDPodiatrist

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.

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

Verify at the official NPI Registry.