Crestus William Roser

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6112 Issued in TN

Practice address

760 Airways Blvd
Savannah, TN 38372-3274

Phone

(731) 607-5157

NPI assigned

Apr 5, 2022

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

45 Urgent Care PC 6 clinicians

Emergency Coverage LLC 761 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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 and National Provider Directory roles.

• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  TN

  Medicare reassignment Care Compare group NPD
• 45 Urgent Care, P.C.

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1912326539

  TN

  Medicare reassignment Care Compare group
• Emergency Medical Care Facilities PC

  • Emergency Medicine Physician
  • Jackson, TN
  • NPI 1538345855

  TN

  Medicare reassignment
• Advanced Rehab and Medical PC

  • Specialist
  • Jackson, TN
  • NPI 1083846703
  NPD (past)

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

• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1639810641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 AIRWAYS BLVD",
            "city": "SAVANNAH",
            "state": "TN",
            "postal_code": "383723274",
            "telephone_number": "731-607-5157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 AIRWAYS BLVD",
            "city": "SAVANNAH",
            "state": "TN",
            "postal_code": "383723274",
            "telephone_number": "731-607-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSER",
        "first_name": "CRESTUS",
        "middle_name": "WILLIAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Robinson
• Rogers Eye Center PC
• Brandy Rogers
• Jerry D Rogers
• Richard N Rogers, OD
• Tammy Ruddle
• Rural Life Foundation, Inc.
• Rxrevive LLC
• Ellen J Saulnier, BA
• Savannah Anesthesia Services LLC

• All providers in Savannah, TN
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.

Verify at the official NPI Registry.