Individual provider Active NPI

Chance Crossland, BS

  • Student in an Organized Health Care Education/Training Program
  • Norcross, GA
National Provider Identifier
1750043352
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
6706 Colchester PL
Norcross, GA 30093-3453
Phone
(770) 298-7889
NPI assigned
Oct 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

6706 Colchester PL
Norcross, GA 30093-3453

Mailing address

6706 Colchester PL
Norcross, GA 30093-3453
Phone (770) 298-7889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220711001823 GA Order and Referring Only - Family PracticePractitioner - Family Practice 2365822129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

NPI Registry JSON

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1750043352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6706 COLCHESTER PL",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933453",
            "telephone_number": "770-298-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6706 COLCHESTER PL",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933453",
            "telephone_number": "770-298-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSLAND",
        "first_name": "CHANCE",
        "name_prefix": "Mr.",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-11",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "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 Norcross, GA

Sources for this page

Verify at the official NPI Registry.