Individual provider Active NPI

Jennifer Tompkins Crutchfield, PHYSICAL THERAPIST

  • Physical Therapist
  • Lincoln, AL
National Provider Identifier
1104023225
Registry record updated Jan 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH5007 Issued in AL
Practice address
141 Magnolia St S
Lincoln, AL 35096-6196
Phone
(205) 873-1657
NPI assigned
Jul 2, 2007
Last updated
Jan 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PTH5007 AL
Physical Therapist 225100000X PTH5007 AL Primary

Addresses

Primary practice location

141 Magnolia St S
Lincoln, AL 35096-6196

Mailing address

246 Woodridge TRL
Oxford, AL 36203-3506
Phone (205) 873-1657

Other practice location 1

1475 1st Ave SW
Jacksonville, AL 36265-3337
Phone (256) 435-9386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180124001393 AL Practitioner - Physical Therapist in Private Practice 5294094058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

141 Magnolia St S
Lincoln, AL 35096-6196
Phone (205) 763-3245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH5007ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings of Alabama, LLC Physical Therapist CurrentSince Jun 14, 2017 Accepting new patients
Rejenerate Health LLC Physical Therapist CurrentSince Sep 21, 2023 Accepting new patients

Locations

1877 Cherokee Ave SW
Cullman, AL 35055
Phone (256) 727-1701

141 Magnolia St S
Lincoln, AL 35096
Phone (205) 763-2400

Organizations & group practices 2

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704499200000",
    "number": "1104023225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 WOODRIDGE TRL",
            "city": "OXFORD",
            "state": "AL",
            "postal_code": "362033506",
            "telephone_number": "205-873-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MAGNOLIA ST S",
            "city": "LINCOLN",
            "state": "AL",
            "postal_code": "350966196",
            "telephone_number": "205-873-1657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1475 1st Ave SW",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "AL",
            "postal_code": "362653337",
            "country_code": "US",
            "telephone_number": "256-435-9386",
            "fax_number": "256-435-2053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUTCHFIELD",
        "first_name": "JENNIFER",
        "middle_name": "TOMPKINS",
        "name_prefix": "Mrs.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2024-01-06",
        "certification_date": "2024-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AL",
            "license": "PTH5007",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH5007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.