Active NPI
J. David Crum, O.D.
- Optometrist
- Augusta, KS
National Provider Identifier
1801889571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1000-3
- Practice address
- 2323 Ohio St
Augusta, KS 67010-2153 - Phone
- (316) 775-6341
- Fax
- (316) 775-6680
- NPI assigned
- Aug 26, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1000-3 | KS | Primary |
Addresses
Primary practice location
2323 Ohio St
Augusta, KS 67010-2153
Mailing address
2323 Ohio St
Augusta, KS 67010-2153
Phone (316) 775-6341
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100090650C | Medicaid | KS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1000 | KS | MD | Marriage & Family Therapist |
| 1000-3 | KS | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199404800000",
"number": "1801889571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2323 OHIO ST",
"city": "AUGUSTA",
"state": "KS",
"postal_code": "670102153",
"telephone_number": "316-775-6341",
"fax_number": "316-775-6680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2323 OHIO ST",
"city": "AUGUSTA",
"state": "KS",
"postal_code": "670102153",
"telephone_number": "316-775-6341",
"fax_number": "316-775-6680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUM",
"first_name": "J.",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-26",
"last_updated": "2008-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KS",
"license": "1000-3",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100090650C",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Augusta, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.