Active NPI
Jadyn Crooch, PT
- Physical Therapist
- Tulsa, OK
National Provider Identifier
1669030359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5691
- Practice address
- 119 E 4TH St
Tulsa, OK 74103-5002 - Phone
- (918) 382-0200
- NPI assigned
- May 29, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5691 | OK | Primary |
Addresses
Primary practice location
119 E 4TH St
Tulsa, OK 74103-5002
Mailing address
703 S Owasso Ave Apt A104
Tulsa, OK 74120-4664
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5691 | OK | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626912000000",
"number": "1669030359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 S OWASSO AVE APT A104",
"city": "TULSA",
"state": "OK",
"postal_code": "741204664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 E 4TH ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741035002",
"telephone_number": "918-382-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROOCH",
"first_name": "JADYN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-29",
"last_updated": "2021-07-22",
"certification_date": "2021-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "5691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.