Individual provider Active NPI

Jared M Croskey, DC

  • Chiropractor
  • Cumming, GA
National Provider Identifier
1174288450
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010648 Issued in GA
Practice address
308 Canton Rd Ste B
Cumming, GA 30040-2215
Phone
(706) 994-4618
NPI assigned
Nov 2, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CHIR010648 GA Primary

Addresses

Primary practice location

308 Canton Rd Ste B
Cumming, GA 30040-2215

Mailing address

1142 Old Roswell Rd
Roswell, GA 30076-1629
Phone (706) 994-4618

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

LicenseStateTypeSpecialty
CHIR010648GAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1174288450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1142 OLD ROSWELL RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761629",
            "telephone_number": "706-994-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 CANTON RD STE B",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402215",
            "telephone_number": "706-994-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSKEY",
        "first_name": "JARED",
        "middle_name": "M",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-02",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.