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CROUCH FAMILY MEDICINE PC
NPI 1609093228
Clinic/Center - Primary Care in Chandler, OK

Active since April 18, 2007CLIA 37D1067992 · Waiver
806 MANVEL AVE, CHANDLER, OK 74834(405) 258-9955(405) 258-9930 Get Directions Write a Review

NPPES record last updated: March 4, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Crouch Family Medicine Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CROUCH FAMILY MEDICINE PC (NPI 1609093228) is a healthcare organization registered as a primary care in Chandler, Oklahoma and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through April 29, 2027 and lists Robin Lee Crouch, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1609093228
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameCROUCH FAMILY MEDICINE PC
Location Address806 MANVEL AVEChandler, OK 74834-3858
Mailing Address806 Manvel AveChandler, OK 74834-3858 · (405) 258-9955 · Fax (405) 258-9930
Phone(405) 258-9955
Fax(405) 258-9930
Organization SubpartNo
Authorized OfficialRobin Lee CrouchBusiness Manager · (405) 258-9955
Enumeration DateApril 18, 2007
Last NPPES UpdateMarch 4, 2013
✔ NPI 1609093228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in OK · 4290
806 MANVEL AVE, Chandler, OK 74834
Open in Google Maps ↗

Other Identifiers 23

Other1618242Coventry Health Care Provider Id #
Other300522328Medicare # For Crouch Family Medicine Pc
Medicare PIN300522328
Other1497890115Npi For Jason Crouch, D.o. (individual)
Other200116510AOK · Medicaid # For Crouch Family Medicine Pc
Other200116520AOK · Medicaid # For Jason Crouch, D.o.
OtherP00465778Railroad Medicare Pt. B Ptan
Medicaid200116520AOK
Other1215222666Npi For Janena Milburn, Aprn, Cnp, Fnp-c
Other1609093228Npi For Crouch Family Medicine (organization)
Other4474235Cigna Healthcare Provider #
Other6147210001OK · Ptan
Medicare NSC6147210001
OtherDG9878Railroad Medicare Pt. B Group Number
Medicaid200116510AOK
Medicare PIN243722101
Medicare PINDG9878
Other243722101Medicare # For Jason Crouch, D.o.
Other9060050Aetna Pin
Other37D1067992Clia # For Crouch Family Medicine Lab (clia-waived Lab)
Other6147210001Dme Ptan For Crouch Family Medicine
OtherOKA104243Medicare Ptan For Janena Milburn, Aprn, Cnp, Fnp-c
Medicare PINP00465778

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Crouch Family Medicine Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Crouch Family Medicine PC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Jason Crouch, D.O.
Family Practice
NPI 1497890115
806 MANVEL AVE
Chandler, OK 74834
(405) 258-9955
✔ PECOS✔ Accepts Medicare0.1 mi
Janena Wilson, FNP
Nurse Practitioner
NPI 1215222666
806 MANVEL AVE
Chandler, OK 74834
(405) 258-9955
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D1067992

Crouch Family Medicine · Chandler, OK
Active · expires Apr 29, 2027
CLIA Number37D1067992
Laboratory TypePhysician Office
Certificate Effective DateApril 30, 2025
Certificate Expiration DateApril 29, 2027
Laboratory DirectorJason M. Crouch, Do
Laboratory Phone(405) 258-9955
Laboratory LocationCrouch Family Medicine806 Manvel Ave, Chandler, OK 74834
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crouch Family Medicine PC's NPI number?

The NPI number for Crouch Family Medicine PC is 1609093228. It was assigned to this organization in the NPPES registry on April 18, 2007.

Where is Crouch Family Medicine PC located?

Crouch Family Medicine PC is located at 806 Manvel Ave, Chandler, OK 74834. The listed phone number is (405) 258-9955.

What is Crouch Family Medicine PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Crouch Family Medicine PC enrolled in Medicare?

Yes. Crouch Family Medicine PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Crouch Family Medicine PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Crouch Family Medicine PC, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Crouch Family Medicine PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D1067992) is associated with this NPI, valid through April 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Crouch Family Medicine PC was last updated on March 4, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.