Crockett Chiropractic, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2001006863 Issued in MO

Legal business name

CROCKETT CHIROPRACTIC, PC

Practice address

733 W Kearney St
Springfield, MO 65803-1229

Phone

(417) 831-7575

Fax

(417) 831-7632

NPI assigned

Dec 27, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Jason Mitchell Crockett, D.C.NPI 1821075375

Title

President

Phone

(417) 831-7575

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Mitchell Crockett, D.C.

  • Chiropractor
  • Springfield, MO
  • NPI 1821075375
  Medicare reassignment Care Compare group Authorized official
• Michael Wayne Jackson, D.C.

  • Chiropractor
  • Springfield, MO
  • NPI 1144207556
  Medicare reassignment Care Compare group
• Jason Corey Goodman, D.C.

  • Chiropractor
  • Saint Charles, MO
  • NPI 1912046889
  NPD (past)

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1326025867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 W KEARNEY ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658031229",
            "telephone_number": "417-831-7575",
            "fax_number": "417-831-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 W KEARNEY ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658031229",
            "telephone_number": "417-831-7575",
            "fax_number": "417-831-7632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROCKETT CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-27",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "CROCKETT",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-831-7575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2001006863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7825256",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "466725",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE OF KANSAS",
            "identifier": "472348",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "143164",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH & CCN",
            "identifier": "1921532",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "4400576",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "9168688",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "755773900",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE9027",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Crisp
• Jennifer D Crites, MD
• Jonathan P. Crites, MD
• Jacob Crocker, DC
• Jessica Ann Crocker, D.C.
• Melinda Ann Crockett-Maples, MD
• Boyd D. Crockett, M.D.
• Jason Mitchell Crockett, D.C.
• Madison Marie Cronin-Burroughs
• Tobey Kay Cronnell, DO

• Chiropractor in Springfield, MO
• Providers in Springfield, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.