Individual provider Active NPI

Jonathan Crowell

  • Family Nurse Practitioner
  • Enid, OK
National Provider Identifier
1477169100
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
80920 Issued in OK
Practice address
3208 W Oklahoma Ave
Enid, OK 73703-5035
Phone
(575) 408-2795
NPI assigned
Sep 17, 2020
Last updated
Sep 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 80920 OK Primary

Addresses

Primary practice location

3208 W Oklahoma Ave
Enid, OK 73703-5035

Mailing address

3208 W Oklahoma Ave
Enid, OK 73703-5035
Phone (575) 408-2795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220223000675 TN Practitioner - Nurse Practitioner 4486048196 Reassigns benefits to 1 organization
I20220426000300 OK Practitioner - Nurse Practitioner 4486048196 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
30897TNMDInternal Medicine Physician
80920OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince Apr 14, 2022 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Dec 20, 2021 Accepting new patients

Locations

2705 S Alma School Rd
Chandler, AZ 85286
Phone (480) 820-7246

10601 S Western Ave
Ste 100
Oklahoma City, OK 73170

300 Montvue Rd
Knoxville, TN 37919
Phone (818) 613-6769

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1477169100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3208 W OKLAHOMA AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737035035",
            "telephone_number": "575-408-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 W OKLAHOMA AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737035035",
            "telephone_number": "575-408-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWELL",
        "first_name": "JONATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "80920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.