Thomas Richard Crutchfield, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

254229 Issued in GA

Practice address

153 Cypress Creek Dr NE
Ludowici, GA 31316-3131

Phone

(912) 271-8678

NPI assigned

Aug 23, 2022

Sex

Male

Sole proprietor

Yes

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

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Southland Optim Jenkins Emergency Medical Services, LLCGroup PAC ID 9537461538, 19 clinicians

Hospital Authority of Liberty CountyGroup PAC ID 5799772190, 15 clinicians

Wayne Emergency Group LLCGroup PAC ID 6103926241, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hospital Authority of Liberty County

  • Critical Access Hospital
  • Hinesville, GA
  • NPI 1326079260

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Southland Optim Jenkins Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Millen, GA
  • NPI 1265826242

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Wayne Emergency Group LLC

  • Emergency Medicine Physician
  • Jesup, GA
  • NPI 1982828943

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Southland Bainbridge Hospitalist Group, LLC

  • Hospitalist Physician
  • Bainbridge, GA
  • NPI 1356735336

  Single Specialty

  Medicare reassignment NPD
• Hospital Authority of Liberty County

  • Orthopaedic Surgery Physician
  • Hinesville, GA
  • NPI 1023443801

  Single Specialty

  NPD
• Hospital Authority of Liberty County

  • Clinic/Center
  • Hinesville, GA
  • NPI 1063903011

  Single Specialty

  NPD
• Southland Optim Jenkins Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Hinesville, GA
  • NPI 1477913580

  Single Specialty

  NPD
• Wills Memorial Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Washington, GA
  • NPI 1275066326

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1306565460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 CYPRESS CREEK DR NE",
            "city": "LUDOWICI",
            "state": "GA",
            "postal_code": "313163131",
            "telephone_number": "912-271-8678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 CYPRESS CREEK DR NE",
            "city": "LUDOWICI",
            "state": "GA",
            "postal_code": "313163131",
            "telephone_number": "912-271-8678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 Elma G Miles Pkwy Ste 102A",
            "address_purpose": "LOCATION",
            "city": "Hinesville",
            "state": "GA",
            "postal_code": "313134000",
            "country_code": "US",
            "telephone_number": "912-369-9400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUTCHFIELD",
        "first_name": "THOMAS",
        "middle_name": "RICHARD",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-23",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "254229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Ludowici, GA
• Providers in Ludowici, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.