NPIMap

Individual provider Active NPI

Hollie G Crutchfield, CRNP

  • Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1891749750
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1088734 Issued in AL
Practice address
1118 Ross Clark Cir
Suite 403
Dothan, AL 36301-3001
Phone
(334) 793-5672
Fax
(334) 794-0378
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1088734 AL Primary

Addresses

Primary practice location

1118 Ross Clark Cir
Suite 403
Dothan, AL 36301-3001

Mailing address

1118 Ross Clark Cir
Suite 403
Dothan, AL 36301-3001
Phone (334) 793-5672

Other identifiers 2

IdentifierTypeStateIssuer
051520456OtherALBCBS OF AL #
051551009MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120321000353 AL Practitioner - Nurse Practitioner 5991965444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston County Healthcare AuthorityGroup PAC ID 9436062296, 256 clinicians

Practice addresses (Care Compare)

1118 Ross Clark Cir
Suite 200
Dothan, AL 36301-3029
Phone (334) 944-4673

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Dothan, AL, CCN 017053
  • Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001
  • Jackson Hospital Hospital, Marianna, FL, CCN 100142
  • Medical Center Barbour Hospital, Eufaula, AL, CCN 011307
  • Donalsonville Hospital Inc Hospital, Donalsonville, GA, CCN 110194
  • Flowers Hospital Hospital, Dothan, AL, CCN 010055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1088734ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hearts South, PC CurrentSince Aug 1, 2001 Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority Nurse Practitioner CurrentSince Apr 1, 2024 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Southeast Alabama Medical Center Employee Pharmacy Past Accepting new patients

Locations

1118 Ross Clark Cir
Ste 403
Dothan, AL 36301
Phone (334) 793-5672

1118 Ross Clark Cir
Ste 200
Dothan, AL 36301
Phone (334) 793-4804

1118 Ross Clark Cir
#406
Dothan, AL 36301

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

102 Doctors Dr
Dothan, AL 36301
Phone (334) 793-8804

101 Professional Ln
Enterprise, AL 36330
Phone (334) 347-3404

Organizations & group practices 6

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1891749750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR",
            "address_2": "SUITE 403",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013001",
            "telephone_number": "334-793-5672",
            "fax_number": "334-794-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR",
            "address_2": "SUITE 403",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013001",
            "telephone_number": "334-793-5672",
            "fax_number": "334-794-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUTCHFIELD",
        "first_name": "HOLLIE",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1088734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL #",
            "identifier": "051520456",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051551009",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.