Jennifer Nicole Crockett, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

0024192617 Issued in VA

Practice address

14300 Justice Rd
Midlothian, VA 23113-6840

Phone

(804) 665-0864

NPI assigned

Feb 17, 2025

Sex

Female

Sole proprietor

No

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 VA

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

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrative Regional Medical Center, PCGroup PAC ID 3577801950, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Integrative Regional Medical Center, P.C.

  • Nurse Practitioner
  • Mechanicsville, VA
  • NPI 1386187540
  Medicare reassignment Care Compare group NPD
• Clark Alliance Services Inc

  • Internal Medicine Physician
  • Alexandria, VA
  • NPI 1952892028
  Medicare reassignment NPD
• Clark Palliative Medicine Group

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Alexandria, VA
  • NPI 1417680612
  Medicare reassignment NPD
• Clark Pulmonary Group

  • Pulmonary Disease Physician
  • Suffolk, VA
  • NPI 1982337242
  NPD

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1649075441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14300 JUSTICE RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231136840",
            "telephone_number": "804-665-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 JUSTICE RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231136840",
            "telephone_number": "804-665-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024192617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crippled Children'S Hospital
• Crippled Children'S Hospital
• Crippled Children'S Hospital
• David Crisafi, MA
• Crisis Care Collective
• Jo Koontz Cronly, D.D.S.
• Gregory William Crook, MD
• Robert D Cross, MD
• Frank Edward Crow, PHD
• Margie L Crow, LCSW

• Acute Care Nurse Practitioner in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Acute Care Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; 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.