Individual provider Active NPI

Aaron Brooks Crofoot, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • South Bend, IN
National Provider Identifier
1285994434
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
01023800A Issued in IN
Practice address
229 W North Shore Dr
South Bend, IN 46617-1142
Phone
(574) 233-7642
NPI assigned
May 22, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 01023800A IN Primary

Addresses

Primary practice location

229 W North Shore Dr
South Bend, IN 46617-1142

Mailing address

229 W North Shore Dr
South Bend, IN 46617-1142
Phone (574) 233-7642

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01023800AINMDEmergency Medical Services (Emergency Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1285994434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 W NORTH SHORE DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171142",
            "telephone_number": "574-233-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W NORTH SHORE DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171142",
            "telephone_number": "574-233-7642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROFOOT",
        "first_name": "AARON",
        "middle_name": "BROOKS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IN",
            "license": "01023800A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; 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.