Active NPI
Christopher Justin Crotty, MD
- Psychiatry Physician
- Winterville, NC
National Provider Identifier
1922561281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 202202307
- Practice address
- 4209 Leicester CT
Winterville, NC 28590-9248 - Phone
- (252) 702-3406
- NPI assigned
- Apr 12, 2019
- Last updated
- Jun 29, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Psychiatry Physician | 2084P0800X | 202202307 | NC | Primary |
Addresses
Primary practice location
4209 Leicester CT
Winterville, NC 28590-9248
Mailing address
4209 Leicester CT
Winterville, NC 28590-9248
Phone (252) 702-3406
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ccrotty289747@direct.vidanthealth.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202202307 | NC | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687996800000",
"number": "1922561281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4209 LEICESTER CT",
"city": "WINTERVILLE",
"state": "NC",
"postal_code": "285909248",
"telephone_number": "252-702-3406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4209 LEICESTER CT",
"city": "WINTERVILLE",
"state": "NC",
"postal_code": "285909248",
"telephone_number": "252-702-3406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROTTY",
"first_name": "CHRISTOPHER",
"middle_name": "JUSTIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-12",
"last_updated": "2023-06-29",
"certification_date": "2023-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "202202307",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ccrotty289747@direct.vidanthealth.com",
"affiliation": "N",
"address_1": "2100 Stantonsburg Rd",
"city": "Greenville",
"state": "NC",
"country_code": "US",
"postal_code": "278342818",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Winterville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.