Active NPI
Ian Crocker, MD
- Radiation Oncology Physician
- Atlanta, GA
National Provider Identifier
1497769715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 028391
- Practice address
- 1365 Clifton Rd NE
Suite A1300
Atlanta, GA 30322-1013 - Phone
- (404) 778-3473
- NPI assigned
- Jul 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 028391 | GA | Primary |
Addresses
Primary practice location
1365 Clifton Rd NE
Suite A1300
Atlanta, GA 30322-1013
Mailing address
1365 Clifton Rd NE
Suite A1300
Atlanta, GA 30322-1013
Phone (404) 778-3473
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
| License | State | Type | Specialty |
|---|---|---|---|
| 028391 | GA | MD | Radiation Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352246400000",
"number": "1497769715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1365 CLIFTON RD NE",
"address_2": "SUITE A1300",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221013",
"telephone_number": "404-778-3473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1365 CLIFTON RD NE",
"address_2": "SUITE A1300",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221013",
"telephone_number": "404-778-3473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROCKER",
"first_name": "IAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-29",
"last_updated": "2012-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "GA",
"license": "028391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.