Charles Douglas Crumpler Jr., M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

M0046 Issued in TX

Practice address

2308 E Villa Maria Rd
Suite 100
Bryan, TX 77802-2549

Phone

(979) 776-0200

Fax

(979) 776-0400

NPI assigned

Sep 12, 2005

Last updated

Jul 5, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Aug 12, 2016 through Aug 12, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Brazos Valley Endocrinology PA

  • Endocrinology, Diabetes & Metabolism Physician
  • Bryan, TX
  • NPI 1952346637
  NPD (past) Authorized official
• Jonathan a. Friedman, M.D., PLLC

  • Physician Assistant
  • Bryan, TX
  • NPI 1629127212
  NPD (past)
• St Joseph Physician Associates

  • Neurological Surgery Physician
  • Bryan, TX
  • NPI 1851405039

  Endocrinology, Diabetes & Metabolism

  NPD (past)

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278288000000",
    "number": "1801881230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 E VILLA MARIA RD",
            "address_2": "SUITE 100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022549",
            "telephone_number": "979-776-0200",
            "fax_number": "979-776-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 E VILLA MARIA RD",
            "address_2": "SUITE 100",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022549",
            "telephone_number": "979-776-0200",
            "fax_number": "979-776-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMPLER",
        "first_name": "CHARLES",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2010-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "M0046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1739732",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "M0046",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1739724",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joe D Crnkovic, ACA
• Joseph Daniel Crnkovic II
• Nicole Rae Crnkovic
• Justin Crouch, PHARMD
• Shameka Crump
• Irma Janette Cruz
• Crystal Tindall FNP PLLC
• Jennifer Lea Culver, M.D.
• Stephanie Kay Cumpton, CRNA
• Samuel Cunningham

• Endocrinology, Diabetes & Metabolism Physician in Bryan, TX
• Providers in Bryan, TX by specialty
• Endocrinology, Diabetes & Metabolism Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.