Individual provider Active NPI

Michael D Crawford, M.D.

  • Otolaryngology Physician
  • Roanoke Rapids, NC
National Provider Identifier
1790781698
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
31262 Issued in NC
Practice address
215 Smith Church Rd
Roanoke Rapids, NC 27870-4913
Phone
(252) 535-2311
Fax
(252) 937-4103
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 31262 NC Primary
Otolaryngic Allergy Physician 207YX0602X 31262 NC

Addresses

Primary practice location

215 Smith Church Rd
Roanoke Rapids, NC 27870-4913

Mailing address

1600 Perimeter Park Dr
Suite 225
Morrisville, NC 27560-8421

Other identifiers 1

IdentifierTypeStateIssuer
8925402MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20050805000504 NC Practitioner - Otolaryngology 3072425214 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31262NCMDOtolaryngic Allergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Wound Specialists of North Carolina, PLLC Otolaryngology CurrentSince Nov 22, 2016 Accepting new patients
Carolina Wound Care Specialists, PLLC CurrentSince Dec 1, 2016 Accepting new patients
Carolina Otolaryngology Consultants PA PastSince Nov 5, 2003 Accepting new patients

Locations

425 Huehl Rd
Bldg 8
Northbrook, IL 60062
Phone (847) 754-4780

35 Memorial Dr
Pinehurst, NC 28374
Phone (910) 715-3376

101 Nash Medical Arts Mall
Rocky Mount, NC 27804
Phone (252) 451-6950

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1790781698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PERIMETER PARK DR",
            "address_2": "SUITE 225",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SMITH CHURCH RD",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704913",
            "telephone_number": "252-535-2311",
            "fax_number": "252-937-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "31262",
            "primary": true
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "NC",
            "license": "31262",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8925402",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke Rapids, NC

Sources for this page

Verify at the official NPI Registry.