Jack Byron Crider, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35982 Issued in KY

Practice address

387 Town Mountain Rd
Ste 202
Pikeville, KY 41501-1640

Phone

(606) 437-1008

Fax

(606) 437-5040

NPI assigned

Sep 20, 2005

Last updated

Jun 12, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Pediatric Medicine

Education

University of Kentucky College of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Spero Health of Kentucky, LLCGroup PAC ID 1052792041, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spero Health of Kentucky, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Danville, KY
  • NPI 1982102109
  Medicare reassignment Care Compare group NPD
• Crider Johnson Pediatrics PSC

  • Pediatrics Physician
  • Pikeville, KY
  • NPI 1114029212
  NPD (past)

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1437145091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 TOWN MOUNTAIN RD",
            "address_2": "STE 202",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011640",
            "telephone_number": "606-437-1008",
            "fax_number": "606-437-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 TOWN MOUNTAIN RD",
            "address_2": "STE 202",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011640",
            "telephone_number": "606-437-1008",
            "fax_number": "606-437-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIDER",
        "first_name": "JACK",
        "middle_name": "BYRON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "35982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1812140000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64031610",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Ray Craft, RBT
• Michael David Cranney, D.O.
• Sarah Elizabeth Crawford, D.O.
• Creative Counseling Associates
• Crider Johnson Pediatrics PSC
• Christopher C Croot, MD
• Crossroads Addiction Recovery Effort, LLC
• James Chumbley Crouch, MD
• Aaron W Crum, M..D.
• James Brandon Crum, D.O.

• Pediatrics Physician in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.