Active NPI
John Driver Crocker, MD
- Diagnostic Radiology Physician
- Jackson, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 36030
- Practice address
- 620 Skyline Drive
Jackson, TN 38301-3901 - Phone
- (731) 541-6174
- NPI assigned
- Mar 2, 2006
- Last updated
- Apr 25, 2017
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 36030 | TN | Primary |
Addresses
Primary practice location
620 Skyline Drive
Jackson, TN 38301-3901
Mailing address
PO Box 11955
Jackson, TN 38308-0132
Phone (731) 541-5000
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4035598 | Other | BCBS | |
| 3873151 | Medicaid | TN | |
| 300130584 | Other | RR MEDICARE | |
| 4102197 | Other | BCBS | |
| 3873150 | Medicaid | TN | |
| 3873155 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Tennessee, HSC, College of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 Garrett Dr
Medina, TN 38355-9641
Phone (731) 422-0355
2859 Hwy 45 Byp
Jackson, TN 38305-3618
Phone (731) 664-1375
2863 Hwy 45 Byp
Jackson, TN 38305-3618
Phone (731) 664-1375
619 Skyline Dr
Jackson, TN 38301-3903
Phone (731) 422-0213
620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000
Hospital & facility affiliations
- Jackson-Madison County General Hospital
- West Tennessee Healthcare Milan Hospital
- Volunteer Community Hospital
- West Tennessee Healthcare Camden Hospital
- Dyersburg Regional Medical Center
- Select Specialty Hospital - West Tennessee
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.15 of 100
- Quality
- 74.15
- Promoting interoperability
- 77
- Improvement activities
- 40
- Cost
- 78.84
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 19 |
| Leg revascularization (restoring blood flow) | 28 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36030 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Imaging of Tennessee | Current | Accepting new patients | |
| Jackson Clinic PA | Diagnostic Radiology | Current | Accepting new patients |
| Jackson Clinic PA | Current | Accepting new patients | |
| Jackson Radiology Associates PA | Diagnostic Radiology | Current | Accepting new patients |
| Jackson Madison County General Hospital | Diagnostic Radiology | Current | Accepting new patients |
| Bolivar General Hospital, Inc. | Past | Accepting new patients | |
| East Georgia Regional Medical Center, LLC | Past | Accepting new patients | |
| Bolivar General Hospital, Inc. | Past | Accepting new patients |
Locations (25 of 26)
650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834
175 Hospital Dr
Camden, TN 38320
Phone (731) 584-6135
1947 Madison St
Ste A
Clarksville, TN 37043
1700 Woodlawn Ave
Dyersburg, TN 38024
Phone (731) 286-1115
3525 Chere Carol Rd
Humboldt, TN 38343
Phone (731) 784-2321
1270 Union University Dr
Ste A
Jackson, TN 38305
Phone (731) 664-0103
17 Centre Plaza Dr
Jackson, TN 38305
Phone (731) 512-0104
244 Coatsland Dr
Jackson, TN 38301
Phone (731) 422-4642
28 Medical Center Dr
Jackson, TN 38301
Phone (731) 427-9971
2859 Highway 45 Byp
Jackson, TN 38305
Phone (731) 660-8360
2863 Highway 45 Byp
Jackson, TN 38305
Phone (731) 660-8300
294 Summar Dr
Jackson, TN 38301
Phone (731) 423-1932
367 Hospital Blvd
Jackson, TN 38305
Phone (731) 661-2000
395 Hospital Blvd
Jackson, TN 38305
Phone (731) 664-7395
620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923
670 Skyline Dr
Jackson, TN 38301
Phone (731) 300-4800
700 W Forest Ave
Ste 200
Jackson, TN 38301
Phone (731) 423-1267
86 Stonebridge Blvd
Jackson, TN 38305
Phone (731) 300-0227
87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375
9 Physicians Dr
Jackson, TN 38305
Phone (731) 661-0086
200 W Church St
Lexington, TN 38351
Phone (731) 968-1812
9550 Highway 412 W
Lexington, TN 38351
Phone (731) 967-3224
161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261
4039 Highland St
Milan, TN 38358
Phone (731) 660-8755
270 E Court Ave
Selmer, TN 38375
Phone (731) 422-0330
Organizations & group practices 8
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.
-
dba JMCGH Radiology Professional
- Diagnostic Radiology Physician
- Jackson, TN
- NPI 1891687208
-
- Diagnostic Radiology Physician
- Jackson, TN
- NPI 1699700716
-
dba Jackson Clinc PA DME
- Durable Medical Equipment & Medical Supplies
- Jackson, TN
- NPI 1689443038
-
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Somerville, TN
- NPI 1073569901
-
dba Bolivar ER
- General Acute Care Hospital
- Bolivar, TN
- NPI 1174545446
-
dba West Tennessee Healthcare Bolivar Hospital
- Critical Access Hospital
- Bolivar, TN
- NPI 1518957950
-
- General Acute Care Hospital
- Statesboro, GA
- NPI 1265486278
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba West Tennessee Healthcare Camden Hospital
- Critical Access Hospital
- Camden, TN
- NPI 1659347920
-
dba Dyersburg Employee Pharmacy
- Community/Retail Pharmacy
- Dyersburg, TN
- NPI 1043282338
Hospital
-
- General Acute Care Hospital
- Jackson, TN
- NPI 1093705428
-
dba West Tennessee Healthcare Volunteer Hospital
- General Acute Care Hospital
- Martin, TN
- NPI 1275505372
-
dba West Tennessee Healthcare Milan Hospital
- General Acute Care Hospital
- Milan, TN
- NPI 1699765453
-
- Long Term Care Hospital
- Jackson, TN
- NPI 1053023713
Long-term care hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493078400000",
"number": "1598732299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11955",
"city": "JACKSON",
"state": "TN",
"postal_code": "383080132",
"telephone_number": "731-541-5000",
"fax_number": "614-210-1886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 SKYLINE DRIVE",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013901",
"telephone_number": "731-541-6174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROCKER",
"first_name": "JOHN",
"middle_name": "DRIVER",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-02",
"last_updated": "2017-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TN",
"license": "36030",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4035598",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3873151",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "300130584",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4102197",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3873150",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3873155",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.