Individual provider Active NPI

Camille R Crawford, MD

  • Pediatrics Physician
  • Florence, KY
National Provider Identifier
1912967027
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
39520 Issued in KY
Practice address
10032 Demia Way
Florence, KY 41042
Phone
(859) 647-6700
Fax
(859) 372-6362
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35051845 OH
Pediatrics Physician 208000000X 39520 KY Primary

Addresses

Primary practice location

10032 Demia Way
Florence, KY 41042

Mailing address

10032 Demia Way
Florence, KY 41042-4734
Phone (859) 647-6700

Other practice location 1

5386 Cox Smith Rd
Suite A
Mason, OH 45040-6803
Phone (513) 770-3466

Other identifiers 2

IdentifierTypeStateIssuer
64045115MedicaidKY
0594441MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39520KYMDPediatrics Physician
35051845OHMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: ccrawford@wholechild.gwaydirect.com

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1912967027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10032 DEMIA WAY",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410424734",
            "telephone_number": "859-647-6700",
            "fax_number": "859-372-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10032 DEMIA WAY",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "41042",
            "telephone_number": "859-647-6700",
            "fax_number": "859-372-6362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5386 Cox Smith Rd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Mason",
            "state": "OH",
            "postal_code": "450406803",
            "country_code": "US",
            "telephone_number": "513-770-3466",
            "fax_number": "513-770-3467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "CAMILLE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35051845",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "39520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64045115",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0594441",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.