Individual provider Active NPI

James Emery Crownover, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Augusta, GA
National Provider Identifier
1306165329
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
074274 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912
Phone
(706) 721-8623
Fax
(706) 721-1459
NPI assigned
Jun 1, 2010
Last updated
Aug 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 074274 GA Primary

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912

Mailing address

1120 15TH St Ste Bi1056
Augusta, GA 30912-0004
Phone (706) 446-5941

Other identifiers 3

IdentifierTypeStateIssuer
GA2126MedicaidSC
003165823FMedicaidGA
003165823EMedicaidGA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171102001285 GA Practitioner - Sports MedicinePractitioner - Physical Medicine and Rehabilitation 9436415775 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc Sports Medicine CurrentSince Nov 1, 2017 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Au Medical Associates Inc CurrentSince Nov 1, 2017 Accepting new patients
Choa Hospital Based, LLC Past Accepting new patients
Children's Orthopaedics of Atlanta P.C. Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1306165329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST STE BI1056",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-446-5941",
            "fax_number": "706-721-9286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30912",
            "telephone_number": "706-721-8623",
            "fax_number": "706-721-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWNOVER",
        "first_name": "JAMES",
        "middle_name": "EMERY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-01",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "GA",
            "license": "074274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GA2126",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003165823F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003165823E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.