Active NPI
Daniel Lind Crocker, M.D.
- Internal Medicine Physician
- Rocky Mount, NC
National Provider Identifier
1700886272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 16848
- Practice address
- 1041 Noell LN
Suite 105
Rocky Mount, NC 27804-2058 - Phone
- (252) 451-2700
- Fax
- (252) 451-2702
- NPI assigned
- Jul 27, 2005
- Last updated
- Sep 21, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 16848 | NC | Primary |
| Hematology & Oncology Physician | 207RH0003X | 16848 | NC |
Addresses
Primary practice location
1041 Noell LN
Suite 105
Rocky Mount, NC 27804-2058
Mailing address
325 Broad St
Ste 100
Sumter, SC 29150-4167
Phone (803) 773-5227
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1105986 | Other | NC | FIRST HEALTH ID |
| 25771 | Other | NC | BC BS OF NC ID |
| 451911 | Other | NC | UNITED HEALTHCARE ID |
| 7106359 | Other | NC | CIGNA HEALTHCARE ID |
| 95350 | Other | NC | MEDCOST ID |
| 5928133 | Other | NC | AETNA ID |
| 8925771 | Medicaid | NC |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16848 | NC | MD | Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537488000000",
"number": "1700886272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 BROAD ST",
"address_2": "STE 100",
"city": "SUMTER",
"state": "SC",
"postal_code": "291504167",
"telephone_number": "803-773-5227",
"fax_number": "803-746-7445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1041 NOELL LN",
"address_2": "SUITE 105",
"city": "ROCKY MOUNT",
"state": "NC",
"postal_code": "278042058",
"telephone_number": "252-451-2700",
"fax_number": "252-451-2702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROCKER",
"first_name": "DANIEL",
"middle_name": "LIND",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-27",
"last_updated": "2018-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "16848",
"primary": true
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "NC",
"license": "16848",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH ID",
"identifier": "1105986",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF NC ID",
"identifier": "25771",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE ID",
"identifier": "451911",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE ID",
"identifier": "7106359",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST ID",
"identifier": "95350",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA ID",
"identifier": "5928133",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8925771",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rocky Mount, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.