Active NPI
Charles Tristan Crawford, PA
- Physician Assistant
- Wilmington, DE
National Provider Identifier
1861065351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1191394
- Practice address
- 10 South TRL
Wilmington, DE 19810-2923 - Phone
- (484) 401-2120
- NPI assigned
- Jul 21, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | E3331533 | ||
| Nurse's Aide | 376K00000X | 10079953 | PA | |
| Physician Assistant | 363A00000X | 1191394 | Primary |
Addresses
Primary practice location
10 South TRL
Wilmington, DE 19810-2923
Mailing address
10 South TRL
Wilmington, DE 19810-2923
Phone (484) 401-2120
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10079953 | PA | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626825600000",
"number": "1861065351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 SOUTH TRL",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198102923",
"telephone_number": "484-401-2120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 SOUTH TRL",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198102923",
"telephone_number": "484-401-2120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAWFORD",
"first_name": "CHARLES",
"middle_name": "TRISTAN",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-21",
"last_updated": "2021-07-21",
"certification_date": "2021-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": null,
"license": "E3331533",
"primary": false
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "PA",
"license": "10079953",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": "1191394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.