Crutchfield Dermatology, P.a.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

CRUTCHFIELD DERMATOLOGY, P.A.

Practice address

1185 Town Centre Dr
Suite 101
Eagan, MN 55123-1187

Phone

(651) 209-3600

NPI assigned

Jul 27, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles E Crutchfield III, M.D.

Title

Owner

Phone

(651) 209-3600

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brooke Alexandra Stein Moss, PA-C

  • Physician Assistant
  • Rogers, MN
  • NPI 1316346950
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962426502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 TOWN CENTRE DR",
            "address_2": "SUITE 101",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231187",
            "telephone_number": "651-209-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 TOWN CENTRE DR",
            "address_2": "SUITE 101",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231187",
            "telephone_number": "651-209-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRUTCHFIELD DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CRUTCHFIELD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-209-3600",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norma Jean Cox, LPC
• Krystan A Coyle, DPT, MBA, OCS
• Meghan Rose Creese
• Nick Allen Crist
• Molly Cronin
• Cummins Counseling LLC
• Gerald Joseph Cunniff Jr., MD
• Cybele Styles LLC
• Maryan A Dahir
• Newal Dahir

• Dermatology Physician in Eagan, MN
• Providers in Eagan, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.