Individual provider Active NPI

Timothy Ellis Crouch, MD

  • Allergy & Immunology Physician
  • Florence, SC
National Provider Identifier
1699832022
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
21204 Issued in SC
Practice address
800 E Cheves St
Ste 420
Florence, SC 29506-2650
Phone
(843) 679-9335
Fax
(843) 669-4214
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 21204 SC Primary

Addresses

Primary practice location

800 E Cheves St
Ste 420
Florence, SC 29506-2650

Mailing address

800 E Cheves St
Ste 420
Florence, SC 29506-2650
Phone (843) 679-9335

Other identifiers 1

IdentifierTypeStateIssuer
212040MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100708000107 SC Practitioner - Allergy/Immunology 0840334132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Medical University of South Carolina College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Asthma Sinus CtrGroup PAC ID 8921067703, 4 clinicians

Practice addresses (Care Compare)

800 E Cheves St
Suite 420
Florence, SC 29506-2649
Phone (843) 679-9335

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Asthma Sinus Ctr Allergy & Immunology CurrentSince Jul 1, 2000 Accepting new patients

Locations

800 E Cheves St
Ste 420
Florence, SC 29506
Phone (843) 679-9335

100 N Sumter St
Ste 405
Sumter, SC 29150

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1699832022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E CHEVES ST",
            "address_2": "STE 420",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062650",
            "telephone_number": "843-679-9335",
            "fax_number": "843-669-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CHEVES ST",
            "address_2": "STE 420",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062650",
            "telephone_number": "843-679-9335",
            "fax_number": "843-669-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "TIMOTHY",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "SC",
            "license": "21204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212040",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.