NPIMap

Individual provider Active NPI

Jane Alice Crick, MD

  • Family Medicine Physician
  • Salisbury, MD
National Provider Identifier
1639269368
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0045995 Issued in MD
Practice address
1665 Woodbrooke Dr
Salisbury, MD 21804-8502
Phone
(410) 546-6650
Fax
(410) 546-2656
NPI assigned
Oct 13, 2006
Last updated
Nov 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33974 NC
Family Medicine Physician 207Q00000X D0045995 MD Primary

Addresses

Primary practice location

1665 Woodbrooke Dr
Salisbury, MD 21804-8502

Mailing address

PO Box 1978
Salisbury, MD 21802-1978
Phone (410) 749-1015

Other identifiers 1

IdentifierTypeStateIssuer
119591300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080904000434 MD Practitioner - Family Practice 2961578513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Eastern Virginia Medical School, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12137 Elm St
Princess Anne, MD 21853-1358
Phone (410) 651-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0045995MDMDFamily Medicine Physician
33974NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Three Lower Counties Community Services, Inc. CurrentSince Jul 14, 2008 Accepting new patients
Three Lower Counties Community Services Inc Current Accepting new patients
Three Lower Counties Community Services, Inc. CurrentSince Jul 14, 2008 Accepting new patients
Three Lower Counties Community Services, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

12137 Elm St
Princess Anne, MD 21853
Phone (410) 651-1000

30413 Mount Vernon Rd
Princess Anne, MD 21853
Phone (410) 219-8356

1665 Woodbrooke Dr
Salisbury, MD 21804
Phone (410) 546-6650

32033 Beaver Run Dr
Salisbury, MD 21804
Phone (410) 860-6600

Interoperability endpoints

  • Direct secure messaging: jane.crick.1@3167.direct.athenahealth.com

Organizations & group practices 5

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 9

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1639269368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 WOODBROOKE DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218048502",
            "telephone_number": "410-546-6650",
            "fax_number": "410-546-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRICK",
        "first_name": "JANE",
        "middle_name": "ALICE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "33974",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0045995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.