Individual provider Active NPI

Mary Anne Crawford, D.C.

  • Chiropractor
  • Red Lion, PA
National Provider Identifier
1790708402
Registry record updated Mar 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC002834L Issued in PA
Practice address
718 S Main St
Red Lion, PA 17356-2605
Phone
(717) 244-8504
Fax
(717) 244-5401
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC002834L PA Primary

Addresses

Primary practice location

718 S Main St
Red Lion, PA 17356-2605

Mailing address

718 S Main St
Red Lion, PA 17356-2605
Phone (717) 244-8504

Other identifiers 2

IdentifierTypeStateIssuer
50041910OtherPACAPITAL BLUE CROSS
4403296OtherPAAETNA

Other names 1

  • Mary Anne Fuller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041008000268 PA Practitioner - Chiropractic 5193784767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

510 N Main St
Suite B
Red Lion, PA 17356-8778
Phone (717) 244-5555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC002834LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Anne Crawford DC LLC Chiropractor CurrentSince Nov 3, 2008 Accepting new patients
Red Lion Chiropractic, Inc. Chiropractor PastSince Feb 7, 1995 Accepting new patients
Pennsylvania Comprehensive Behavioral Health Services, LLC PastSince Mar 20, 2022 Accepting new patients

Organizations & group practices 3

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206921600000",
    "number": "1790708402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 S MAIN ST",
            "city": "RED LION",
            "state": "PA",
            "postal_code": "173562605",
            "telephone_number": "717-244-8504",
            "fax_number": "717-244-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 S MAIN ST",
            "city": "RED LION",
            "state": "PA",
            "postal_code": "173562605",
            "telephone_number": "717-244-8504",
            "fax_number": "717-244-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "MARY",
        "middle_name": "ANNE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC002834L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50041910",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4403296",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FULLER",
            "middle_name": "ANNE",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Red Lion, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.