Nathan A Crouch, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009653 Issued in IL

Practice address

3101 Fields South Dr
Champaign, IL 61822-3743

Phone

(217) 366-1250

NPI assigned

Jun 20, 2005

Last updated

Jan 6, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christie Clinic, PLLCGroup PAC ID 7719899319, 219 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ncrouchod311166@carlehiedirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christie Clinic, PLLC

  • Internal Medicine Physician
  • Champaign, IL
  • NPI 1871523829
  Medicare reassignment Care Compare group NPD
• James R Ruppel MD LLC

  • Ophthalmology Physician
  • Galesburg, IL
  • NPI 1427241710
  NPD (past)

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1750386215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203981",
            "telephone_number": "217-366-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 FIELDS SOUTH DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618223743",
            "telephone_number": "217-366-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "NATHAN",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009653",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "05832113",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ncrouchod311166@CarleHieDirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3101 Fields South Dr",
            "city": "Champaign",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618223743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Shevonda Carol Crowder, LSW,LMSW, SSW
• Daniel Bryant Crowley
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• Jennifer Larkin Crozier, LMT
• Debra L Cruickshank, MSW LCSW CSW-G

• Optometrist in Champaign, IL
• Providers in Champaign, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.