Individual provider Active NPI

Jerrall P Crook, MD

  • General Practice Physician
  • Nashville, TN
National Provider Identifier
1306131370
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
3446 Issued in TN
Practice address
145 Thompson LN
Nashville, TN 37211-2411
Phone
(615) 781-0013
Fax
(615) 781-0688
NPI assigned
Jun 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 3446 TN
Family Medicine Physician 207Q00000X 3446 TN
Internal Medicine Physician 207R00000X 3446 TN
General Practice Physician 208D00000X 3446 TN Primary

Addresses

Primary practice location

145 Thompson LN
Nashville, TN 37211-2411

Mailing address

145 Thompson LN
Nashville, TN 37211-2411
Phone (615) 781-0013

Other identifiers 1

IdentifierTypeStateIssuer
10834071OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111004000783 TN Practitioner - General PracticePractitioner - Allergy/ImmunologyPractitioner - Otolaryngology 7618149287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3446TNMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1306131370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 THOMPSON LN",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372112411",
            "telephone_number": "615-781-0013",
            "fax_number": "615-781-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 THOMPSON LN",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372112411",
            "telephone_number": "615-781-0013",
            "fax_number": "615-781-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOK",
        "first_name": "JERRALL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "3446",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "3446",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "3446",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "3446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10834071",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.