Edgar P Crockett, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00001214 Issued in WA

Practice address

70 Andover Park W
Tukwila, WA 98188

Phone

(206) 439-7588

Fax

(206) 241-6857

NPI assigned

Dec 6, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dr. John E. Daun and Associates,Inc.,P.S.

  • Clinic/Center
  • Gig Harbor, WA
  • NPI 1184954588
  NPD
• Auburn Eyecare Center, LLC

  • Optometrist
  • Auburn, WA
  • NPI 1720152895
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801955737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 ANDOVER PARK W",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "98188",
            "telephone_number": "206-439-7588",
            "fax_number": "206-241-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 ANDOVER PARK W",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "98188",
            "telephone_number": "206-439-7588",
            "fax_number": "206-241-6857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "EDGAR",
        "middle_name": "P",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2021384",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CP Seattle Wa Hospice, LLC
• Robin R Crabtree
• Alicia Craig-Davis
• Italia Crichton
• Jackie Crisp
• Layna Marie Crofts, MSW
• Anna Cronin
• Monica Rae Croonquist, CD
• Margaret Macchiarini Crosson
• Katherine Aileen Crow

• Optometrist in Tukwila, WA
• Providers in Tukwila, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.