Individual provider Active NPI

Jared Allen Crothers, M.D.

  • Otolaryngology Physician
  • Gainesville, FL
National Provider Identifier
1104052042
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME155474 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-2502
Phone
(352) 273-5199
Fax
(352) 392-6781
NPI assigned
Jun 5, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 46624 TN
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 0101282293 VA
Otolaryngology Physician 207Y00000X ME155474 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-2502

Mailing address

PO Box 100264
Gainesville, FL 32610-0264
Phone (352) 273-5199

Other practice location 1

895 City Center Blvd Ste 152
Newport News, VA 23606-3080
Phone (757) 599-5505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241113002784 VA Practitioner - Otolaryngology 8224353115 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Medical University of South Carolina College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

895 City Ctr Blvd
Suite 152
Newport News, VA 23606-3080
Phone (757) 599-5505

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME155474FLMDOtolaryngology Physician
46624TNMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Regional Medical Group CurrentSince Oct 4, 2024 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services, Inc. Otolaryngology CurrentSince May 12, 2025 Accepting new patients
Chesapeake Regional Medical Group CurrentSince Oct 4, 2024 Accepting new patients
Riverside Physician Services Inc CurrentSince May 12, 2025 Accepting new patients

Locations

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

113 Gainsborough Sq
Ste 400
Chesapeake, VA 23320
Phone (757) 436-0167

300 Medical Pkwy
Chesapeake, VA 23320
Phone (757) 312-6102

895 City Center Blvd
Ste 152
Newport News, VA 23606
Phone (757) 599-5505

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

Interoperability endpoints

  • Direct secure messaging: jcrothers264546@direct.rivhs.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1104052042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100264",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100264",
            "telephone_number": "352-273-5199",
            "fax_number": "352-392-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326102502",
            "telephone_number": "352-273-5199",
            "fax_number": "352-392-6781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "895 City Center Blvd Ste 152",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236063080",
            "country_code": "US",
            "telephone_number": "757-599-5505",
            "fax_number": "757-599-3618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROTHERS",
        "first_name": "JARED",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-05",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "46624",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "VA",
            "license": "0101282293",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME155474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.