Individual provider Active NPI

Jamie Marie Crossman, DDS

  • General Practice Dentistry
  • Hamilton, MT
National Provider Identifier
1053353912
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1841 Issued in MT
Practice address
299 Fairgrounds Rd
Suite #2
Hamilton, MT 59840-3199
Phone
(406) 363-1911
Fax
(406) 363-3022
NPI assigned
Jun 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1841 MT Primary

Addresses

Primary practice location

299 Fairgrounds Rd
Suite #2
Hamilton, MT 59840-3199

Mailing address

299 Fairgrounds Rd
Suite #2
Hamilton, MT 59840-3199
Phone (406) 363-1911

Other identifiers 2

IdentifierTypeStateIssuer
0130208MedicaidMT
5512338OtherMTBLUE CHIP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160209001102 MT Order and Referring Only - DentistPractitioner - Dentist 6305849035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1841MTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jamie M. Bacon Crossman, DDS, PC General Practice PastSince Mar 21, 2006 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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053353912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 FAIRGROUNDS RD",
            "address_2": "SUITE #2",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598403199",
            "telephone_number": "406-363-1911",
            "fax_number": "406-363-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 FAIRGROUNDS RD",
            "address_2": "SUITE #2",
            "city": "HAMILTON",
            "state": "MT",
            "postal_code": "598403199",
            "telephone_number": "406-363-1911",
            "fax_number": "406-363-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSMAN",
        "first_name": "JAMIE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "1841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0130208",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "5512338",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, MT

Sources for this page

Verify at the official NPI Registry.