Individual provider Active NPI

Jess Hunley Crawford III, D.C.

  • Chiropractor
  • Waldorf, MD
National Provider Identifier
1235304072
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1891 Issued in MD
Practice address
975 Chandler CT
Waldorf, MD 20602-2800
Phone
(301) 638-4300
Fax
(301) 638-1090
NPI assigned
Apr 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1891 MD Primary

Addresses

Primary practice location

975 Chandler CT
Waldorf, MD 20602-2800

Mailing address

975 Chandler CT
Waldorf, MD 20602-2800
Phone (301) 638-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081210000335 MD Practitioner - Chiropractic 7810058757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chiropractic Care Center Inc.Group PAC ID 2668533597, 2 clinicians

Practice addresses (Care Compare)

957 Chandler CT
Waldorf, MD 20602-2800
Phone (301) 638-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1891MDMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Care Center Inc. Chiropractor CurrentSince Oct 27, 1998 Accepting new patients

Locations

957 Chandler Ct
Waldorf, MD 20602
Phone (301) 638-4300

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1235304072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 CHANDLER CT",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022800",
            "telephone_number": "301-638-4300",
            "fax_number": "301-638-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 CHANDLER CT",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022800",
            "telephone_number": "301-638-4300",
            "fax_number": "301-638-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "JESS",
        "middle_name": "HUNLEY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "1891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.