Individual provider Active NPI

Edwin Fulghum Crandley, MD

  • Radiation Oncology Physician
  • Norfolk, VA
National Provider Identifier
1750510236
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
0101255429 Issued in VA
Practice address
600 Gresham Dr
Norfolk, VA 23507-1904
Phone
(757) 388-3483
Fax
(757) 627-0334
NPI assigned
Jul 6, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 0101255429 VA Primary

Addresses

Primary practice location

600 Gresham Dr
Norfolk, VA 23507-1904

Mailing address

PO Box 936
Norfolk, VA 23501-0936
Phone (757) 388-3483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20140711001626 VA Practitioner - Radiation Oncology 6406086255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Eastern Virginia Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1060 1St Colonial Rd
Virginia BCH, VA 23454-3002
Phone (757) 395-8610

600 Gresham Dr
Norfolk, VA 23507-1904

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Evms Academic Physicians and Surgeons Health Services Foundation Radiation Oncology CurrentSince Jul 21, 2014 Accepting new patients

Locations

3000 Coliseum Dr
Ste 104
Hampton, VA 23666
Phone (757) 827-9400

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

2800 Godwin Blvd
Suffolk, VA 23434
Phone (757) 363-6850

1060 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 395-2323

1950 Glenn Mitchell Dr
Ste 102
Virginia Beach, VA 23456
Phone (757) 368-0437

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.

Hospital & facility affiliations 6

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": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1750510236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235010936",
            "telephone_number": "757-388-3483",
            "fax_number": "757-627-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-3483",
            "fax_number": "757-627-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDLEY",
        "first_name": "EDWIN",
        "middle_name": "FULGHUM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-06",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "VA",
            "license": "0101255429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.