NPIMap

Individual provider Active NPI

Suzanne Catherine Crandall, D.O.

  • Neurology Physician
  • Charleston, WV
National Provider Identifier
1679761498
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
3679 Issued in WV
Practice address
415 Morris St Ste 300
Charleston, WV 25301-1853
Phone
(304) 388-6441
Fax
(304) 388-6445
NPI assigned
Oct 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2009007653 MO
Neurology Physician 2084N0400X 5101016555 MI
Neurology Physician 2084N0400X 3679 WV Primary

Addresses

Primary practice location

415 Morris St Ste 300
Charleston, WV 25301-1853

Mailing address

415 Morris St Ste 300
Charleston, WV 25301-1853
Phone (304) 388-6441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, WV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090715000508 MO Practitioner - Neurology 8921150384 Reassigns benefits to 2 organizations
I20210525002458 WV Practitioner - Neurology 8921150384 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

314 Goff Mountain Rd
Suite 3
Cross Lanes, WV 25313-6600
Phone (304) 388-7070

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101016555MIMDNeurology Physician
2009007653MOMDNeurology Physician
3679WVMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Missouri Medical Center CurrentSince Aug 29, 2009 Accepting new patients
Western Missouri Medical Center CurrentSince Aug 29, 2009 Accepting new patients
Preston Memorial Hospital Corporation CurrentSince Dec 28, 2025 Accepting new patients
Cass Regional Medical Center CurrentSince Aug 16, 2011 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Apr 6, 2021 Accepting new patients
Cass Regional Medical Center CurrentSince Aug 16, 2011 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Apr 6, 2021 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Neurological Consultants of Kansas City, Inc Neurology Past Accepting new patients
Charleston Area Medical Center, Inc. Past Accepting new patients

Locations

2800 E Rock Haven Rd
Harrisonville, MO 64701
Phone (816) 380-3474

403 Burkarth Rd
Warrensburg, MO 64093
Phone (660) 474-2500

407 Burkarth Rd
Ste 302
Warrensburg, MO 64093
Phone (660) 747-2500

415 Morris St
Ste 300
Charleston, WV 25301
Phone (304) 345-6303

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

314 Goff Mountain Rd
Ste 3
Cross Lanes, WV 25313
Phone (304) 388-7070

150 Memorial Dr
Kingwood, WV 26537
Phone (304) 329-4701

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/preston-adacdb24

Organizations & group practices 10

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1679761498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MORRIS ST STE 300",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011853",
            "telephone_number": "304-388-6441",
            "fax_number": "304-388-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MORRIS ST STE 300",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011853",
            "telephone_number": "304-388-6441",
            "fax_number": "304-388-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "SUZANNE",
        "middle_name": "CATHERINE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2009007653",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "5101016555",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WV",
            "license": "3679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.