Individual provider Active NPI

Donal L Crowder, PHD

  • Psychologist
  • Leland, NC
National Provider Identifier
1912916065
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5414 Issued in NC
Practice address
1168 E Cutlar Xing
Leland, NC 28451-6484
Phone
(910) 332-3800
Fax
(910) 251-0421
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 934-057 WI
Psychologist 103T00000X 5414 NC Primary

Addresses

Primary practice location

1168 E Cutlar Xing
Leland, NC 28451-6484

Mailing address

1168 E Cutlar Xing
Leland, NC 28451-6484
Phone (910) 332-3800

Other identifiers 1

IdentifierTypeStateIssuer
39029800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922003572 NC Practitioner - Clinical Psychologist 1254320872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

1168 E Cutlar Xing
Leland, NC 28451-6426
Phone (919) 220-5255

Merit-based Incentive Payment System (MIPS)

Final score
89.07 of 100Reported as group
Quality
85.94
Promoting interoperability
100
Improvement activities
40
Cost
77.63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
934-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA CurrentSince Sep 8, 2021 Accepting new patients
Emergeortho PA Psychologist CurrentSince Sep 8, 2021 Accepting new patients
Burlington Behavioral Health, LLC PastSince Oct 13, 2009 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

1168 E Cutlar Crossing
Leland, NC 28451
Phone (814) 836-8113

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

3787 Shipyard Blvd
Wilmington, NC 28403
Phone (910) 341-2444

Interoperability endpoints

  • Direct secure messaging: don.crowder.1@847.direct.athenahealth.com

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1912916065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1168 E CUTLAR XING",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284516484",
            "telephone_number": "910-332-3800",
            "fax_number": "910-251-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1168 E CUTLAR XING",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284516484",
            "telephone_number": "910-332-3800",
            "fax_number": "910-251-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWDER",
        "first_name": "DONAL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "934-057",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "5414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39029800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leland, NC

Sources for this page

Verify at the official NPI Registry.