Mark A Crump, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

28957 Issued in GA

Practice address

708 S 8TH St
Griffin, GA 30224-4827

Phone

(770) 228-5402

Fax

(770) 412-6917

NPI assigned

Aug 9, 2005

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 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Mark a. Crump, MD, PC

  • Internal Medicine Physician
  • Griffin, GA
  • NPI 1710029947
  Authorized official Same address or phone
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  dba WellStar Creekside Pediatrics

  • Pediatrics Physician
  • Douglasville, GA
  • NPI 1912203050
  NPD

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1558362897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244827",
            "telephone_number": "770-228-5402",
            "fax_number": "770-412-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244827",
            "telephone_number": "770-228-5402",
            "fax_number": "770-412-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMP",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "28957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "581936002",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000332758A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcrump343581@directwellstar.org",
            "affiliation": "N",
            "address_1": "708 S 8th St",
            "city": "Griffin",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302244827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Angel Crawford, OTR/L
• Sherry Creamer, RN
• Crosby Mitchell Counseling Services LLP
• Brian Cross, M.D.
• Crosspoint Dental LLC
• Terilynn Culverhouse, LPC
• Mark William Cvengros-Edens, APRN
• D Brian Remington MD PC
• Lina Basil Dahman, PT, DPT
• Alyson Dallas

• Internal Medicine Physician in Griffin, GA
• Providers in Griffin, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.