William Crouch (NPI# 1104878016, PAC ID# 0143127134) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1104878016 |
| PAC ID by PECOS | 0143127134 |
| Professional Enrollment ID | I20070215000748 |
| Full Name | William Crouch |
| Organization Legal Name | PRIME HEALTH OF NORTH PORT LLC |
| Address |
2975 Bobcat Village Ctr Rd Suite 100 North Port FL 34288-4603 |
| Phone Number | 9414239936 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE |
| Graduation Year | 1997 |
| Primary Specialty | FAMILY PRACTICE |
| Group Practice PAC ID | 5890776751 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100087 | SARASOTA MEMORIAL HOSPITAL |
| 100077 | BAYFRONT HEALTH PORT CHARLOTTE |
| Address | Phone | Organization |
|---|---|---|
| 2975 Bobcat Village Ctr Rd, Suite 100, North Port, FL 34288-4603 | 9414239936 | PRIME HEALTH OF NORTH PORT LLC |
| Organization Legal Name | PRIME HEALTH OF NORTH PORT LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lee Gross | Family Practice | Prime Health of North Port LLC | 2975 Bobcat Village Ctr Rd, Suite 100, North Port, FL 34288-4603 |
| Street Address |
2975 BOBCAT VILLAGE CTR RD SUITE 100 |
| City | NORTH PORT |
| State | FL |
| Zip | 34288-4603 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Candice D Martens Nicoll | Nurse Practitioner | 2975 Bobcat Village Ctr Rd, Suite 100, North Port, FL 34288-4603 | |
| Lee Gross | Family Practice | Prime Health of North Port LLC | 2975 Bobcat Village Ctr Rd, Suite 100, North Port, FL 34288-4603 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Erin L Pantano | Physical Therapy | Fitness Quest - North Port LLC | 2530 Bobcat Village Ctr Rd C, North Port, FL 34288-8475 |
| Francisco Ramirez | Physical Therapy | Fitness Quest - North Port LLC | 2530 Bobcat Village Ctr Rd, Unit C, North Port, FL 34288-8475 |
| Mallory Vetter | Physical Therapy | Fitness Quest - North Port LLC | 2530 Bobcat Village Ctr Rd, Unit C, North Port, FL 34288-8475 |
| Nikita Kalinoski | Physical Therapy | Fitness Quest - North Port LLC | 2530 Bobcat Village Ctr Rd, Unit C, North Port, FL 34288-8475 |
| Melissa A Leisenring | Physical Therapy | Fitness Quest - North Port LLC | 2530 Bobcat Village Ctr Rd, Unit C, North Port, FL 34288-8475 |
| George Toth | Family Practice | Smh Physician Services Inc | 2345 Bobcat Village Ctr Rd, Suite 202, North Port, FL 34288-8997 |
| Janet Kralik Lewis | Internal Medicine | Smh Physician Services Inc | 2345 Bobcat Village Ctr Rd, Unit 202, North Port, FL 34288-8999 |
| City | NORTH PORT |
| Zip Code | 34288 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | NORTH PORT + FAMILY PRACTICE |
Please comment or provide details below to improve the information on William Crouch.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.