Active NPI
Garr J Crookston, AU.D.
- Audiologist-Hearing Aid Fitter
- Alameda, CA
National Provider Identifier
1104999200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist-Hearing Aid Fitter
- License
- 108267-4101
- Practice address
- 2314 Central Ave
Alameda, CA 94501-4514 - Phone
- (510) 865-8113
- Fax
- (510) 865-8115
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist-Hearing Aid Fitter | 237600000X | 108267-4101 | UT | Primary |
Addresses
Primary practice location
2314 Central Ave
Alameda, CA 94501-4514
Mailing address
2314 Central Ave
Alameda, CA 94501-4514
Phone (510) 865-8113
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00001814488-05 | Other | UT | UHC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 108267-4101 | UT | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeside Audiology LLC | Audiologist-Hearing Aid Fitter | Past | Accepting new patients |
| Robinson Audiology, LLC. | Audiologist-Hearing Aid Fitter | Past | Accepting new patients |
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 and National Provider Directory roles.
-
dba Logan Hearing Zone & Brigham City Hearing Zone
- Audiologist-Hearing Aid Fitter
- Logan, UT
- NPI 1699005389
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335398400000",
"number": "1104999200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2314 CENTRAL AVE",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945014514",
"telephone_number": "510-865-8113",
"fax_number": "510-865-8115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2314 CENTRAL AVE",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945014514",
"telephone_number": "510-865-8113",
"fax_number": "510-865-8115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROOKSTON",
"first_name": "GARR",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2012-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "UT",
"license": "108267-4101",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "00001814488-05",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alameda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.