Individual provider Active NPI

Dorwyn Wayne Croom II, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Morganton, NC
National Provider Identifier
1346202157
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
23371 Issued in NC
Practice address
2201 S Sterling St
Morganton, NC 28655-4044
Phone
(828) 580-6117
Fax
(828) 580-6109
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 23371 NC Primary

Addresses

Primary practice location

2201 S Sterling St
Morganton, NC 28655-4044

Mailing address

PO Box 52990
Greenwood, SC 29649-0048
Phone (864) 223-3600

Other identifiers 2

IdentifierTypeStateIssuer
11307OtherNCBCBS #
8926222MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23371NCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Pathology Associates Anatomic Pathology & Clinical Pathology Current Accepting new patients

Locations

2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1346202157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52990",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296490048",
            "telephone_number": "864-223-3600",
            "fax_number": "864-223-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 S STERLING ST",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554044",
            "telephone_number": "828-580-6117",
            "fax_number": "828-580-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOM",
        "first_name": "DORWYN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "23371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS #",
            "identifier": "11307",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8926222",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morganton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.