Individual provider Active NPI

Eric Crumbaugh, PHARMD

  • Pharmacist
  • Little Rock, AR
National Provider Identifier
1750524013
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PD10734 Issued in AR
Practice address
10100 Stagecoach Rd
Little Rock, AR 72210-5742
Phone
(501) 455-2522
NPI assigned
Apr 15, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD10734 AR Primary

Addresses

Primary practice location

10100 Stagecoach Rd
Little Rock, AR 72210-5742

Mailing address

108 Ryker LN
Benton, AR 72019-2171
Phone (870) 761-0980

Other practice location 1

6929 JFK Blvd
North Little Rock, AR 72116-5312
Phone (870) 761-0980

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PD10734ARMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
NW Otter Creek LLC CurrentSince Sep 28, 2021 Accepting new patients
SC Pharmacy Group Opco LLC PastSince Sep 28, 2021 Accepting new patients

Locations

10100 Stagecoach Rd
Little Rock, AR 72210
Phone (501) 455-2522

Organizations & group practices 2

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": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1750524013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 RYKER LN",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720192171",
            "telephone_number": "870-761-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 STAGECOACH RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722105742",
            "telephone_number": "501-455-2522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6929 JFK Blvd",
            "address_purpose": "LOCATION",
            "city": "North Little Rock",
            "state": "AR",
            "postal_code": "721165312",
            "country_code": "US",
            "telephone_number": "870-761-0980",
            "fax_number": "501-835-6531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUMBAUGH",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-15",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD10734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.