Active NPI
Ronald M. Crockett, D.C.
- Chiropractor
- Salem, OR
National Provider Identifier
1700916855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1472
- Practice address
- 4070 Macleay Rd SE
Salem, OR 97317-5801 - Phone
- (503) 371-9796
- Fax
- (503) 371-8265
- NPI assigned
- Mar 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1472 | OR | Primary |
Addresses
Primary practice location
4070 Macleay Rd SE
Salem, OR 97317-5801
Mailing address
4070 Macleay Rd SE
Salem, OR 97317-5801
Phone (503) 371-9796
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Western States College of Chiropractic, 1979
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4070 Macleay Rd SE
Salem, OR 97317-5801
Phone (503) 371-9796
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1472 | OR | MD | Physical Therapist |
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.
-
- Chiropractor
- Salem, OR
- NPI 1558392019
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352937600000",
"number": "1700916855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4070 MACLEAY RD SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973175801",
"telephone_number": "503-371-9796",
"fax_number": "503-371-8265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4070 MACLEAY RD SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973175801",
"telephone_number": "503-371-9796",
"fax_number": "503-371-8265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROCKETT",
"first_name": "RONALD",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-07",
"last_updated": "2012-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "1472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.