Individual provider Active NPI

Charles Thomas Crinnian, MD

  • Neurology Physician
  • Scottsdale, AZ
National Provider Identifier
1902081375
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
21041 Issued in AZ
Practice address
9003 E Shea Blvd
Scottsdale, AZ 85260-6709
Phone
(480) 323-3000
NPI assigned
Jan 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 21041 AZ Primary

Addresses

Primary practice location

9003 E Shea Blvd
Scottsdale, AZ 85260-6709

Mailing address

7351 E Osborn Rd
Attn: Physician Business Services
Scottsdale, AZ 85251-6451
Phone (480) 882-4335

Other identifiers 1

IdentifierTypeStateIssuer
168915MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050929000401 AZ Practitioner - NeurologyPractitioner - Preventive Medicine 5799710604 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Ambulatory Current Accepting new patients
Honorhealth Ambulatory CurrentSince Jun 1, 2008 Accepting new patients
Honorhealth Ambulatory CurrentSince Jun 1, 2008 Accepting new patients
Charles T. Crinnian, MD PC Neurology PastSince Jan 1, 1990 Accepting new patients

Locations

313 S Beeline Hwy
Payson, AZ 85541
Phone (928) 472-7107

2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

9003 E Shea Blvd
Scottsdale, AZ 85260
Phone (480) 323-3383

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1902081375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7351 E OSBORN RD",
            "address_2": "ATTN: PHYSICIAN BUSINESS SERVICES",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516451",
            "telephone_number": "480-882-4335",
            "fax_number": "480-882-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9003 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606709",
            "telephone_number": "480-323-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRINNIAN",
        "first_name": "CHARLES",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-04",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "21041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168915",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.