John William Crom, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

002940 Issued in MN

Practice address

215 N 2ND Ave
Suite 1
Proctor, MN 55810-2230

Phone

(218) 722-4265

Fax

(218) 722-4265

NPI assigned

Mar 20, 2007

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497870059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N 2ND AVE",
            "address_2": "SUITE 1",
            "city": "PROCTOR",
            "state": "MN",
            "postal_code": "558102230",
            "telephone_number": "218-722-4265",
            "fax_number": "218-722-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N 2ND AVE",
            "address_2": "SUITE 1",
            "city": "PROCTOR",
            "state": "MN",
            "postal_code": "558102230",
            "telephone_number": "218-722-4265",
            "fax_number": "218-722-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROM",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "002940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN",
            "identifier": "3K196CR",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROCARE ID",
            "identifier": "231588",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN LICENSE NUMBER",
            "identifier": "2940",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Lawrence Bopp, DDS
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• Rachel Elaine Carlsen, APRN, CNP
• Erica Anne Chopskie, RN
• Brian Cox
• Diamond Willow Living LLC
• FCSL Proctor, LLC
• FCSL Proctor, LLC
• FCSL Proctor, LLC
• FCSL Proctor, LLC

• Chiropractor in Proctor, MN
• Providers in Proctor, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.