CHARLES E. CRUTCHFIELD III (NPI# 1578566840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578566840 |
| Entity Type | Individual |
| Full Name | CHARLES E. CRUTCHFIELD III |
| Credential | M.D |
| Practice Address |
1185 Town Centre Dr Ste 101 Eagan MN 55123-1188 |
| Practice Telephone | 6512093600 |
| Practice Fax Number | 6512093601 |
| Mailing Telephone | 6512093600 |
| Mailing Fax Number | 6512093601 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2010-06-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 40670 | MN | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871703801 | Charles Dwayne Crutchfield | Chiropractor | 519 Donelson Pike Ste 107, Nashville, TN 37214-3700 | 2007-05-22 |
| 1699734244 | Charles Edward Crutchfield | Obstetrics & Gynecology | 409 Dunlap St N, Saint Paul, MN 55104-4201 | 2006-03-22 |
| Street Address |
1185 TOWN CENTRE DR STE 101 |
| City | EAGAN |
| State | MN |
| Zip Code | 55123-1188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518583590 | Virginia Otey Villarreal | Registered Nurse | 1185 Town Centre Dr, Eagan, MN 55123-1187 | 2020-06-24 |
| 1639510845 | Anna Lynn Connelly | Specialist/Technologist | 1185 Town Centre Dr, Suite 100, Eagan, MN 55123-1187 | 2013-07-16 |
| 1639326861 | Pamela O Strobel | Physician Assistant | 1185 Town Centre Dr, Suite 220, Eagan, MN 55123-1187 | 2008-08-19 |
| 1952587099 | Adam S. Kim | Internal Medicine | 1185 Town Centre Dr, Suite 200, Eagan, MN 55123-1187 | 2008-01-19 |
| 1225134240 | Vernon Claude Jesse | Psychologist | 1185 Town Centre Dr, Suite 225, Eagan, MN 55123-1186 | 2006-09-16 |
| 1215033238 | Mark Patrick Kerekes | Psychiatry & Neurology | 1185 Town Centre Dr, Suite 225 Bhsi LLC, Eagan, MN 55123-1186 | 2006-09-16 |
| 1962426502 | Crutchfield Dermatology, P.a. | Dermatology | 1185 Town Centre Dr, Suite 101, Eagan, MN 55123-1187 | 2006-07-27 |
| 1164477709 | Minnesota Center for Obesity, Metabolism & Endocrinology, Pa | Family Medicine | 1185 Town Centre Dr, Suite 220, Eagan, MN 55123-1187 | 2006-05-23 |
| 1720033640 | Joseph Michael Gonzalez-campoy | Internal Medicine | 1185 Town Centre Dr, Suite 220, Eagan, MN 55123-1187 | 2006-05-23 |
| 1831144609 | Ayesha Ebrahim | Internal Medicine | 1185 Town Centre Dr, Suite 220, Eagan, MN 55123-1187 | 2006-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053828467 | Hilltop Family Chiropractic Center Pa | Chiropractor | 1121 Town Centre Drive Suite 202, Eagan, MN 55123 | 2018-01-08 |
| 1922452507 | Jacob Zimmerman | Counselor | 3450 O'leary Ln., Eagan, MN 55123 | 2016-04-20 |
| 1316320971 | K-squared Fitness, L.L.C. | Public Health or Welfare | 1100 Cliff Rd, Eagan, MN 55123 | 2015-07-01 |
| 1346683687 | Joshua M Dorn | Allergy & Immunology | 3460 Promenade Ave, Eagan, MN 55123 | 2013-04-16 |
| 1700172350 | Mary Christine Mcnabney | Nurse Practitioner | 610 Opperman Drive, D4 Health Center, Your Wellbeing Health Center, Eagan, MN 55123 | 2011-06-22 |
| 1033353669 | Todd Borstad | Social Worker | 3450 O'leary Lane, Eagan, MN 55123 | 2009-04-27 |
| 1821025271 | Mngi Endoscopy LLC | Clinic/Center | 1185 Town Centre Drive, Eagan, MN 55123 | 2006-06-28 |
| 1780620120 | Cindy Eileen Wood | Audiologist | 3440 Oleary Lane, 240, Eagan, MN 55123 | 2006-06-22 |
| 1609845742 | Jeffery R Dichter | Internal Medicine | 849 Govern Circle, Saint Paul, MN 55123 | 2006-03-14 |
| 1891269155 | Elise Broderick Quam | Social Worker | 3450 Oleary Ln, Eagan, MN 55123 | 2019-01-18 |
| Find all providers in zip 55123 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336451178 | Kellie L Haehnel | Specialist | 3435 Washington Dr, Ste 206, Eagan, MN 55122-1339 | 2010-07-09 |
| 1588859367 | Meagan M Binenstock | Specialist | 2119 Cliff Rd, Eagan, MN 55122-2345 | 2007-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245846369 | Cyprian O Marubi | Specialist | 2021 E Hennepin Ave Ste 402, Minneapolis, MN 55413-1867 | 2020-09-23 |
| 1992327415 | Julie Baker | Specialist | 907 W Central Entrance, Duluth, MN 55811-5469 | 2020-05-07 |
| 1710521257 | Karly Bauer | Specialist | 512 30th Ave E Ste 10, Alexandria, MN 56308-5096 | 2019-10-28 |
| 1447816632 | Advanced Brain and Body Clinic Pllc | Specialist | 126 N 3rd St Ste 402, Minneapolis, MN 55401-2838 | 2019-05-14 |
| 1184181349 | Beverly Teresa Brending | Specialist | 745 Grand Ave Ste 101, Saint Paul, MN 55105-3384 | 2019-02-25 |
| 1982190294 | Lori Hunt | Specialist | 6425 Flying Cloud Dr, Eden Prairie, MN 55344-4555 | 2018-07-10 |
| 1346769692 | Darci Stanford | Specialist | 130 E Vine St, Owatonna, MN 55060-2428 | 2017-09-18 |
| 1407397250 | Malcolm Watt | Specialist | 7 Cannon St W, Dundas, MN 55019-4039 | 2017-03-13 |
| 1821532284 | Diana Mason | Specialist | 8170 Hillcrest Dr Ne, Bemidji, MN 56601-8993 | 2016-12-05 |
| 1649726910 | Rebecca Hoffman Pllc | Specialist | 3400 1st Street N, Suite 300, St. Cloud, MN 56301 | 2016-08-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.