Active NPI
Jacob Douglas Cronk, DO
- Student in an Organized Health Care Education/Training Program
- Lumberton, NC
National Provider Identifier
1689422818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 300 W 27TH St
Lumberton, NC 28358-3075 - Phone
- (910) 735-8786
- NPI assigned
- May 13, 2024
- Last updated
- May 13, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
300 W 27TH St
Lumberton, NC 28358-3075
Mailing address
300 W 27TH St
Lumberton, NC 28358-3075
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240813001685 | NC | Order and Referring Only - General Surgery | 0446798144 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1689422818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W 27TH ST",
"city": "LUMBERTON",
"state": "NC",
"postal_code": "283583075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W 27TH ST",
"city": "LUMBERTON",
"state": "NC",
"postal_code": "283583075",
"telephone_number": "910-735-8786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRONK",
"first_name": "JACOB",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-13",
"last_updated": "2024-05-13",
"certification_date": "2024-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lumberton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.