Jennifer Ellen Crossman, LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

1101003906 Issued in VA

Practice address

16375 Merchants LN
King George, VA 22485-5655

Phone

(540) 413-3141

Fax

(540) 644-0719

NPI assigned

Jun 1, 2023

Last updated

Jun 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jecross.s05779@us.wal-mart.com

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1124711437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16375 MERCHANTS LN",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224855655",
            "telephone_number": "540-413-3141",
            "fax_number": "540-644-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16375 MERCHANTS LN",
            "city": "KING GEORGE",
            "state": "VA",
            "postal_code": "224855655",
            "telephone_number": "540-413-3141",
            "fax_number": "540-644-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSMAN",
        "first_name": "JENNIFER",
        "middle_name": "ELLEN",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "VA",
            "license": "1101003906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JECROSS.S05779@US.WAL-MART.COM",
            "affiliation": "N",
            "address_1": "16375 Merchants Ln",
            "city": "King George",
            "state": "VA",
            "country_code": "US",
            "postal_code": "224855655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Optician in King George, VA
• Providers in King George, VA by specialty
• Optician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.