Nicole Lynne Crockford, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

A945 Issued in SC

Practice address

2030 North Church Place
Spartanburg, SC 29303

Phone

(864) 582-6858

Fax

(864) 583-9360

NPI assigned

May 4, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1265480065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 ADDLESTONE WAY",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293348963",
            "telephone_number": "864-415-5025",
            "fax_number": "864-583-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 NORTH CHURCH PLACE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29303",
            "telephone_number": "864-582-6858",
            "fax_number": "864-583-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKFORD",
        "first_name": "NICOLE",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "A945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crescent Anesthesia Associates
• Charles Edward Crite Jr.
• Alexis Crocker, OTD, OTR/L
• Brooke Ellison Crocker, PA
• Christopher Thomas Crocker, PA-C
• Croft Rescue Squad, Inc
• Claudia M. Croitoru, M.D.
• Ashley Taylor Cromer, RN
• Kevin L Cromer, NP
• Casey Jack Cronan, DO

• Physician Assistant in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.