Jerry Marvin Crowe Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS004037 Issued in TN

Practice address

1109 N Eastman Rd
Kingsport, TN 37664-3156

Phone

(423) 245-9071

Fax

(423) 245-9474

NPI assigned

Jan 25, 2007

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 TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316093396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 N EASTMAN RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376643156",
            "telephone_number": "423-245-9071",
            "fax_number": "423-245-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 N EASTMAN RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376643156",
            "telephone_number": "423-245-9071",
            "fax_number": "423-245-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWE",
        "first_name": "JERRY",
        "middle_name": "MARVIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS004037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey B Cross, FNP
• Kyle K Cross
• Terri Jeanne Cross, MA
• Donna Howard Crotts, COTA
• Jack R Crowder, M.D.
• Jennifer Marie Crowley-Rodig, ARNP
• Chelsea Jeanette Cruey, RN
• Julia Wallin Culligan, PH.D.
• Lauren Ashley Cullins, APRN, CPNP-AC
• Benjamin Culp, MD

• General Practice Dentistry in Kingsport, TN
• Providers in Kingsport, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.