Active NPI
Austin Vance Crocker, PHARMD
- Pharmacist
- Holly Springs, MS
National Provider Identifier
1518457670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-14998
- Practice address
- 145 E Van Dorn Ave
Holly Springs, MS 38635-3096 - Phone
- (662) 252-2322
- NPI assigned
- May 15, 2018
- Last updated
- May 15, 2018
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-14998 | MS | Primary |
Addresses
Primary practice location
145 E Van Dorn Ave
Holly Springs, MS 38635-3096
Mailing address
145 E Van Dorn Ave
Holly Springs, MS 38635-3025
Phone (662) 252-2322
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-14998 | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526342400000",
"number": "1518457670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 E VAN DORN AVE",
"city": "HOLLY SPRINGS",
"state": "MS",
"postal_code": "386353025",
"telephone_number": "662-252-2322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 E VAN DORN AVE",
"city": "HOLLY SPRINGS",
"state": "MS",
"postal_code": "386353096",
"telephone_number": "662-252-2322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROCKER",
"first_name": "AUSTIN",
"middle_name": "VANCE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-15",
"last_updated": "2018-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-14998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holly Springs, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.