Richard Andrews Crandall III, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0420012390 Issued in VT

Practice address

1093 Brookfield Rd
Berlin, VT 05602-9065

Phone

(717) 368-6346

NPI assigned

Nov 16, 2007

Last updated

Sep 9, 2020By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clearchoicemd Primary Care PLLC

  • Family Medicine Physician
  • Saint Albans, VT
  • NPI 1326582529
  NPD (past)

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1902087190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1093 BROOKFIELD RD",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056029065",
            "telephone_number": "717-368-6346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1093 BROOKFIELD RD",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056029065",
            "telephone_number": "717-368-6346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "RICHARD",
        "middle_name": "ANDREWS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-16",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "0420012390",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G88844",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32001803",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021110",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellia Cohen, LICSW
• Michael S Cohn, M.D.
• Collin Kwasnik, DDS, Inc.
• Matthew Alexander Collins, MD
• Jessica Cotnoir
• Mark E. Crane, MD
• Denis Daigneault, R.PH.
• Peter Allen Dale, MD
• Jedidiah P. Danforth, BA
• Robert R Davidson, PA-C

• Family Medicine Physician in Berlin, VT
• Providers in Berlin, VT by specialty
• Family Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.