Active NPI
Edward Evans Crowe, O.D.
- Optometrist
- South Boston, VA
National Provider Identifier
1740287176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0618000490
- Practice address
- 1328 Seymour Dr
South Boston, VA 24592-3914 - Phone
- (434) 575-7360
- Fax
- (434) 575-7618
- NPI assigned
- Jun 30, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0618000490 | VA | Primary |
Addresses
Primary practice location
1328 Seymour Dr
South Boston, VA 24592-3914
Mailing address
PO Box 795
South Boston, VA 24592-0795
Phone (434) 575-7360
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9203842 | Medicaid | VA | |
| 075525 | Other | VA | ANTHEM |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211241600000",
"number": "1740287176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 795",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245920795",
"telephone_number": "434-575-7360",
"fax_number": "434-575-7618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1328 SEYMOUR DR",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245923914",
"telephone_number": "434-575-7360",
"fax_number": "434-575-7618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROWE",
"first_name": "EDWARD",
"middle_name": "EVANS",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-30",
"last_updated": "2008-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VA",
"license": "0618000490",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9203842",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "075525",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Boston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.