John Walton Crowder, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DDS 4312 Issued in TN

Practice address

39 Murray Guard Dr
Jackson, TN 38305-3610

Phone

(731) 660-7799

NPI assigned

Dec 28, 2005

Last updated

Aug 5, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 3, 2016 through Nov 3, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• John W. Crowder, D.D.S.,P.C.

  • Dental Clinic/Center
  • Jackson, TN
  • NPI 1396903811
  NPD (past) Authorized official

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1497732861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 MURRAY GUARD DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053610",
            "telephone_number": "731-660-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 MURRAY GUARD DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053610",
            "telephone_number": "731-660-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWDER",
        "first_name": "JOHN",
        "middle_name": "WALTON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DDS 4312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal D Crosser, APNP
• Hannah L Crossett, LPC
• Timothy Ray Crossett, MD
• Crossroads Urgent Care, PLLC (Urgent Team)
• Mary Ann Crouse
• Justin Edward Crowder, M.ED.
• Lindsey Crowder
• Lisa R Crowell, FNP
• Mark H Crowell, LCSW
• Catherine Watson Crutchfield, RN

• Oral and Maxillofacial Surgery (Dentist) in Jackson, TN
• Providers in Jackson, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.