Individual provider Active NPI

John Driver Crocker, MD

  • Diagnostic Radiology Physician
  • Jackson, TN
National Provider Identifier
1598732299
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
36030 Issued in TN
Practice address
620 Skyline Drive
Jackson, TN 38301-3901
Phone
(731) 541-6174
NPI assigned
Mar 2, 2006
Last updated
Apr 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
4035598OtherBCBS
3873151MedicaidTN
300130584OtherRR MEDICARE
4102197OtherBCBS
3873150MedicaidTN
3873155MedicaidTN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040206000200 TN Practitioner - Diagnostic Radiology 1951294537 Reassigns benefits to 3 organizations

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
Jackson Clinic PAGroup PAC ID 2668376872, 171 clinicians
Jackson Radiology Associates PAGroup PAC ID 6305893231, 28 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
74.15
Promoting interoperability
77
Improvement activities
40
Cost
78.84

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal19
Leg revascularization (restoring blood flow)28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36030TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Imaging of Tennessee CurrentSince May 30, 2019 Accepting new patients
Jackson Clinic PA Diagnostic Radiology CurrentSince Mar 23, 2015 Accepting new patients
Jackson Clinic PA CurrentSince Mar 23, 2015 Accepting new patients
Jackson Radiology Associates PA Diagnostic Radiology CurrentSince Jun 1, 2005 Accepting new patients
Jackson Madison County General Hospital Diagnostic Radiology CurrentSince Oct 1, 2025 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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.