Kenneth Cody Crouch, DPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

11888 Issued in OK

Practice address

1631 A East Hwy 66
El Reno, OK 73036

Phone

(405) 262-7631

Fax

(405) 262-8099

NPI assigned

May 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Cody Crouch Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• El Reno Indian Health Center

  • Public Health or Welfare Agency
  • El Reno, OK
  • NPI 1386725604
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912129461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 W DEBBIE",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736441200",
            "telephone_number": "580-225-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 A EAST HWY 66",
            "city": "EL RENO",
            "state": "OK",
            "postal_code": "73036",
            "telephone_number": "405-262-7631",
            "fax_number": "405-262-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "KENNETH",
        "middle_name": "CODY",
        "name_prefix": "Mr.",
        "credential": "DPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "11888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CODY",
            "last_name": "CROUCH",
            "prefix": "MR.",
            "credential": "DPH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dontae Jamahl Cooper, LPC-A
• Kimmy Sue-Vandiver Cooper
• Counseling Services of El Reno
• Nikki Cox
• Sarah Cromwell, OTL
• Patrick Allen Culley, PHARM.D.
• Cristi Alaina Cullum, LPN
• Melissa Lucille Curley, LPN
• April Wine Curtis
• Brittany Renee Dalal

• Pharmacist in El Reno, OK
• Providers in El Reno, OK by specialty
• Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.