Charles Brenden Croughan

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2115 Leiter Rd
Miamisburg, OH 45342-3600

Phone

(937) 384-6800

NPI assigned

Mar 28, 2021

Last updated

Jan 30, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1811574429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423600",
            "telephone_number": "937-384-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423600",
            "telephone_number": "937-384-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUGHAN",
        "first_name": "CHARLES",
        "middle_name": "BRENDEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-28",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GU",
            "license": "TLL-2024-001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy D Crawford, PA-C
• Dwight Crawford
• N. Ray Crawford, LPN
• Crestwood Select Homes
• Kiaira Crockett, PTA
• Dylan J Crowell, MD
• Giessel Amanda Cruz, RBT
• Paolo Jose Cuculicchio, MD
• Lindsay Michelle Cummings, M.A. CCC-SLP
• Alexis Curtiss, RBT

• Student in an Organized Health Care Education/Training Program in Miamisburg, OH
• Providers in Miamisburg, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.