Jack W Crosland, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

159595-1205 Issued in UT

Practice address

2240 Adams Ave
Ogden, UT 84401-1511

Phone

(801) 393-5355

Fax

(801) 394-4609

NPI assigned

Aug 19, 2005

Last updated

Nov 22, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midtown Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Ogden, UT
  • NPI 1548267420
  Medicare reassignment NPD
• Midtown Community Health Center Inc

  dba MTCHC Logan Clinic

  • Federally Qualified Health Center (FQHC)
  • Logan, UT
  • NPI 1053780171
  NPD
• Midtown Community Health Center Inc

  dba Midtown CHC Children's

  • Federally Qualified Health Center (FQHC)
  • Washington Terrace, UT
  • NPI 1013186717
  NPD (past)
• Ogden Orthopaedic Specialists LLC

  • Orthopaedic Surgery Physician
  • Ogden, UT
  • NPI 1629023858
  NPD (past)

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1750373247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 ADAMS AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844011511",
            "telephone_number": "801-393-5355",
            "fax_number": "801-394-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 ADAMS AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844011511",
            "telephone_number": "801-393-5355",
            "fax_number": "801-394-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSLAND",
        "first_name": "JACK",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": "159595-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "68969",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "QM000053820",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "6273",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHB",
            "identifier": "05391",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "810680455A005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC",
            "identifier": "107004879101",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870680455007",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS",
            "identifier": "870680455CRO",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert D Crofts, MD
• Jeremy Cleon Crookston, PHARMD
• Kimalee Crookston
• Maline Johanna Cropper, FNP-C
• Hope Crosland, PHARMD
• Cross Country Holdings, P.C. (OC Medical)
• Crosscountry Health,, P.C. (Ogden Chiropractic Center)
• Crossroads Academy
• Chad R Crowther, DO
• Deserey Crowther, CF-SLP

• Orthopaedic Surgery Physician in Ogden, UT
• Providers in Ogden, UT by specialty
• Orthopaedic Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.