Individual provider Active NPI

Justin Dwayne Crawford

  • Surgical Assistant
  • Lubbock, TX
National Provider Identifier
1700541463
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
184775 Issued in TX
Practice address
1121 77TH St
Lubbock, TX 79423-4529
Phone
(214) 227-2457
Fax
(214) 764-0880
NPI assigned
Nov 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 184775 TX
Surgical Assistant 246ZC0007X 184775 TX Primary

Addresses

Primary practice location

1121 77TH St
Lubbock, TX 79423-4529

Mailing address

PO Box 2550
Rowlett, TX 75030-2550
Phone (214) 227-2457

Other practice location 1

3615 19th St
Lubbock, TX 79410-1203
Phone (806) 725-0000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
184775TXMDSurgical Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas Surgical Assisting LLC Surgical Assistant CurrentSince Nov 16, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1636243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1700541463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2550",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750302550",
            "telephone_number": "214-227-2457",
            "fax_number": "214-764-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 77TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794234529",
            "telephone_number": "214-227-2457",
            "fax_number": "214-764-0880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3615 19th St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794101203",
            "country_code": "US",
            "telephone_number": "806-725-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "JUSTIN",
        "middle_name": "DWAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-07",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "184775",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "184775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.

Verify at the official NPI Registry.