Jason Douglas Crawford, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

12776-040 Issued in WI

Practice address

660 S Grand Ave
Sun Prairie, WI 53590-9832

Phone

(608) 834-5601

NPI assigned

Nov 21, 2006

Last updated

Dec 11, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1114092640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 ACEWOOD BLVD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537161213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S GRAND AVE",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535909832",
            "telephone_number": "608-834-5601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Business Park Cir",
            "address_purpose": "LOCATION",
            "city": "Stoughton",
            "state": "WI",
            "postal_code": "535893392",
            "country_code": "US",
            "telephone_number": "608-873-1342",
            "fax_number": "608-873-4009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "JASON",
        "middle_name": "DOUGLAS",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SD",
            "license": "4971",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "12776-040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "4971",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "12776-040",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Sun Prairie, WI
• Providers in Sun Prairie, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.