Individual provider Active NPI

David E Crocker

  • Home Health Aide
  • Washington, DC
National Provider Identifier
1487464913
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
374U00000X Issued in DC
Practice address
4020 Minnesota Ave. S.E.
402
Washington, DC 20020-2001
Phone
(202) 808-5712
NPI assigned
Jan 8, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X
Home Health Aide 374U00000X 374U00000X DC Primary

Addresses

Primary practice location

4020 Minnesota Ave. S.E.
402
Washington, DC 20020-2001

Mailing address

1511 Morris Rd SE
Washington, DC 20020-4412
Phone (202) 808-5712

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
374U00000XDCMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1736294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1487464913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 MORRIS RD SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200204412",
            "telephone_number": "202-808-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 MINNESOTA AVE. S.E.",
            "address_2": "402",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200202001",
            "telephone_number": "202-808-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "DAVID",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "374U00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.