NPIMap

Individual provider Active NPI

Marshall J Crowther, M.D.

  • Pediatric Sports Medicine Physician
  • University, MS
National Provider Identifier
1639197494
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
23389 Issued in MS
Practice address
400 Rebel Drive
University, MS 38677
Phone
(662) 915-7274
NPI assigned
Jul 18, 2006
Last updated
Dec 15, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 27417 AL
Pediatrics Physician 208000000X 24443 SC
Pediatric Sports Medicine Physician 2080S0010X 23389 MS Primary

Addresses

Primary practice location

400 Rebel Drive
University, MS 38677

Mailing address

PO Box 1848
400 Rebel Drive
University, MS 38677-1848
Phone (662) 915-7274

Other identifiers 7

IdentifierTypeStateIssuer
51113111OtherALBCBS
104966MedicaidAL
114548MedicaidAL
P00799667OtherALRAILROAD MEDICARE
051593910OtherALBCBS
125307MedicaidAL
51100240OtherALBCBS

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27417ALMDOrthopaedic Surgery Physician
24443SCMDPediatrics Physician
23389MSMDPediatric Sports Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Sports Medicine and Ortho Center Orthopaedic Surgery Past Accepting new patients
Andrews Sports Medicine and Orthopaedic Center Past Accepting new patients
Univ. of Miss. Student Health Service Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1639197494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1848",
            "address_2": "400 REBEL DRIVE",
            "city": "UNIVERSITY",
            "state": "MS",
            "postal_code": "386771848",
            "telephone_number": "662-915-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 REBEL DRIVE",
            "city": "UNIVERSITY",
            "state": "MS",
            "postal_code": "38677",
            "telephone_number": "662-915-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWTHER",
        "first_name": "MARSHALL",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AL",
            "license": "27417",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "24443",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "MS",
            "license": "23389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51113111",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104966",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114548",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00799667",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051593910",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125307",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51100240",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in University, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.