Individual provider Active NPI

Joseph Howe Crumbliss, M.D.

  • Family Medicine Physician
  • Abilene, TX
National Provider Identifier
1962491829
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F4797 Issued in TX
Practice address
1680 Antilley Rd
Suite 135
Abilene, TX 79606-5267
Phone
(325) 428-5540
Fax
(325) 428-5545
NPI assigned
Oct 13, 2005
Last updated
Oct 15, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F4797 TX Primary

Addresses

Primary practice location

1680 Antilley Rd
Suite 135
Abilene, TX 79606-5267

Mailing address

1680 Antilley Rd
Suite 135
Abilene, TX 79606-5267
Phone (325) 428-5540

Other identifiers 1

IdentifierTypeStateIssuer
110352501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060123000436 TX Practitioner - Family Practice 2264456854

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group West Texas, PLLC Past Accepting new patients
Privia Medical Group West Texas, PLLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1962491829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 ANTILLEY RD",
            "address_2": "SUITE 135",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065267",
            "telephone_number": "325-428-5540",
            "fax_number": "325-428-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 ANTILLEY RD",
            "address_2": "SUITE 135",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065267",
            "telephone_number": "325-428-5540",
            "fax_number": "325-428-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMBLISS",
        "first_name": "JOSEPH",
        "middle_name": "HOWE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F4797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110352501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.