Charles N Crenshaw III, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

09099 Issued in MS

Practice address

216 Avalon Cir Ste a
Brandon, MS 39047-7843

Phone

(601) 992-6511

Fax

(601) 992-5684

NPI assigned

Aug 8, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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 and National Provider Directory roles.

• River Oaks Management Company LLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1922029040
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1942210497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 AVALON CIR STE A",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477843",
            "telephone_number": "601-992-6511",
            "fax_number": "601-992-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 AVALON CIR STE A",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477843",
            "telephone_number": "601-992-6511",
            "fax_number": "601-992-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRENSHAW",
        "first_name": "CHARLES",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "09099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Elizabeth Courtney, DNP, FNP-C
• Amanda Kim Covault, CRNA
• Amanda Nicole Cox
• Talisa M Cox
• Macie Craddock, PT
• Amanda Myrick Cribbs, CRNA
• Jasmine M Crosby, FNP
• Crossgates Family Doctors
• Crossgates Hma Medical Group LLC
• Crossgates Hma Medical Group, LLC

• Family Medicine Physician in Brandon, MS
• Providers in Brandon, MS by specialty
• Family Medicine Physician in Mississippi

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