Active NPI
Crayton A Fargason, M.D.
- Pediatrics Physician
- Birmingham, AL
National Provider Identifier
1972520054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 15776
- Practice address
- 1600 7TH Ave S
Birmingham, AL 35233-1711 - Phone
- (205) 939-9585
- Fax
- (205) 975-6503
- NPI assigned
- Jul 16, 2006
- Last updated
- Jan 14, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 15776 | AL | Primary |
Addresses
Primary practice location
1600 7TH Ave S
Birmingham, AL 35233-1711
Mailing address
703 Volker Hall
Birmingham, AL 35294-0001
Phone (205) 934-3795
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000084225 | Medicaid | AL | |
| 000028871 | Medicaid | AL | |
| 515-25378 | Other | AL | BC BS |
| 009999725 | Medicaid | AL | |
| E82823 | Other | VIVA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15776 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Children's Hospital of Alabama | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Children's Health System
- Children's Hospital
- Birmingham, AL
- NPI 1205935012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294963200000",
"number": "1972520054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 VOLKER HALL",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352940001",
"telephone_number": "205-934-3795",
"fax_number": "205-975-2499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 7TH AVE S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352331711",
"telephone_number": "205-939-9585",
"fax_number": "205-975-6503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARGASON",
"first_name": "CRAYTON",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-16",
"last_updated": "2011-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AL",
"license": "15776",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000084225",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000028871",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS",
"identifier": "515-25378",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009999725",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIVA",
"identifier": "E82823",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.