Individual provider Active NPI

John Martin Crowe Jr., M.D.

  • Family Medicine Physician
  • Fenton, MO
National Provider Identifier
1093709057
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036118309 Issued in IL
Practice address
1670 Fenpark Dr
Fenton, MO 63026-2918
Phone
(636) 492-6376
Fax
(636) 326-6557
NPI assigned
Sep 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2023012237 MO
Family Medicine Physician 207Q00000X 35234 IA
Family Medicine Physician 207Q00000X 036118309 IL Primary

Addresses

Primary practice location

1670 Fenpark Dr
Fenton, MO 63026-2918

Mailing address

1670 Fenpark Dr
Fenton, MO 63026-2918
Phone (636) 492-6376

Other practice location 1

1722 Clarkson Rd
Chesterfield, MO 63017-4976
Phone (636) 206-2665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230714001233 MO Practitioner - Family Practice 0345324018 Reassigns benefits to 1 organization
I20260224000999 TN Practitioner - Family Practice 0345324018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11000 Optum Cir
Eden Prairie, MN 55344-2503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35234IAMDFamily Medicine Physician
036118309ILMDFamily Medicine Physician
2023012237MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Tennessee CurrentSince Feb 1, 2026 Accepting new patients
Medexpress Urgent Care Missouri P.C. CurrentSince Aug 10, 2025 Accepting new patients
Medexpress Urgent Care, PC - Tennessee CurrentSince Feb 1, 2026 Accepting new patients
Mercy East Ambulatory Services LLC CurrentSince Jul 10, 2023 Accepting new patients

Locations

1722 Clarkson Rd
Chesterfield, MO 63017
Phone (636) 206-2665

1670 Fenpark Dr
Fenton, MO 63026
Phone (636) 492-6376

409 Lafayette Ctr
Manchester, MO 63011
Phone (636) 707-0764

901 Patients First Dr
Ste 1200
Washington, MO 63090
Phone (636) 390-1777

1 Bethel Valley Rd
Oak Ridge, TN 37830
Phone (865) 574-7431

Interoperability endpoints

  • Direct secure messaging: john.crowe.1@27404.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1093709057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 FENPARK DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262918",
            "telephone_number": "636-492-6376",
            "fax_number": "636-326-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 FENPARK DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262918",
            "telephone_number": "636-492-6376",
            "fax_number": "636-326-6557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1722 Clarkson Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630174976",
            "country_code": "US",
            "telephone_number": "636-206-2665",
            "fax_number": "636-206-2664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROWE",
        "first_name": "JOHN",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2023012237",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "35234",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036118309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.