Jimmie Conrad Crawford, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10002163A Issued in IN

Practice address

2015 Jackson St
Anderson, IN 46016-4337

Phone

(765) 646-8439

NPI assigned

Dec 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 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Floridian Emergency Specialists LLC

  • Emergency Medicine Physician
  • Melbourne, FL
  • NPI 1710210695
  Medicare reassignment
• Floridian Emergency Specialists, LLC

  • Emergency Medicine Physician
  • Crestview, FL
  • NPI 1992150007
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Coastal Radiology Associates PA

  • Diagnostic Radiology Physician
  • Fort Walton Beach, FL
  • NPI 1750524393
  NPD (past)
• Crestview Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Crestview, FL
  • NPI 1144458647
  NPD (past)
• Escambia River Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Pensacola, FL
  • NPI 1215361662

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503273600000",
    "number": "1619151099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 PITNEY DR",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "46062",
            "telephone_number": "765-646-8439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 JACKSON ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164337",
            "telephone_number": "765-646-8439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "JIMMIE",
        "middle_name": "CONRAD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-20",
        "last_updated": "2017-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002163A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2930196 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harmony Leigh Craig, RBT
• Kimberly Anne Craig, FNP-C
• Ranisha Craig
• James Crain
• Michelle L Cramer, LCSW
• Karmen Lee Creel, LCSW
• Stephen W Creel, LCSW
• Joan D Crockett, M.D.
• Adam Crosby, M.A., LAT, ATC
• Hannah Crum

• Physician Assistant in Anderson, IN
• Providers in Anderson, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.