Individual provider Active NPI

William Matthew Crook, PA-C

  • Surgical Physician Assistant
  • Saint Marys, GA
National Provider Identifier
1265455364
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
004782 Issued in GA
Practice address
2060 Dan Proctor Dr Ste 1400
Saint Marys, GA 31558-3895
Phone
(912) 576-6355
NPI assigned
Jul 26, 2006
Last updated
Oct 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 004782 GA Primary

Addresses

Primary practice location

2060 Dan Proctor Dr Ste 1400
Saint Marys, GA 31558-3895

Mailing address

2060 Dan Proctor Dr Ste 1400
Saint Marys, GA 31558-3895
Phone (912) 576-6355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060828000529 GA Practitioner - Physician Assistant 9830193119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Effingham Rehab Services, LLCGroup PAC ID 5597752063, shared by 3 NPIs, 143 clinicians
Cooperative Healthcare Services IncGroup PAC ID 9830093640, 235 clinicians

Practice addresses (Care Compare)

1390 Boone Ave Ext
Suite A23
Kingsland, GA 31548-6515
Phone (419) 221-3717

2000 Dan Proctor Dr
Saint Marys, GA 31558-3810
Phone (912) 576-6200

2060 Dan Proctor Dr
Saint Marys, GA 31558-3895

2415 Parkwood Dr
Brunswick, GA 31520-4722
Phone (912) 466-4079

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.36 of 100Reported as group
Quality
46.72
Promoting interoperability
99
Improvement activities
40
Cost
75.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4782GAMDProfessional Counselor
004782GAMDVeterinarian

Interoperability endpoints

  • Direct secure messaging: wcrook@secure.sghsmessaging.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1265455364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 DAN PROCTOR DR STE 1400",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583895",
            "telephone_number": "912-576-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 DAN PROCTOR DR STE 1400",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583895",
            "telephone_number": "912-576-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOK",
        "first_name": "WILLIAM",
        "middle_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "004782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, GA

Sources for this page

Verify at the official NPI Registry.