Edward Frank Crocker Jr., M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

17871 Issued in MS

Practice address

255 Baptist Blvd
Suite 401
Columbus, MS 39705-2011

Phone

(662) 244-2288

Fax

(662) 244-2289

NPI assigned

Jun 23, 2006

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 2

Medicare fee-for-service enrollment

Enrolled in MS

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edward.crocker.1@15070.direct.athenahealth.com

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.

• Noxubee General Critical Access Hospital

  • Emergency Medicine Physician
  • Macon, MS
  • NPI 1477793305

  MS

  Medicare reassignment NPD
• Correct Care, Inc.

  • Emergency Medicine Physician
  • Covington, LA
  • NPI 1215987441

  MS

  Medicare reassignment NPD
• Noxubee General Critical Access Hospital

  • Community/Retail Pharmacy
  • Macon, MS
  • NPI 1134616113
  NPD
• Vicksburg Clinic LLC

  • Infectious Disease Physician
  • Vicksburg, MS
  • NPI 1659307791
  NPD (past)
• Vicksburg Clinic LLC

  • Family Medicine Physician
  • Vicksburg, MS
  • NPI 1790711158
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1770519951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "telephone_number": "901-227-3255",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 BAPTIST BLVD",
            "address_2": "SUITE 401",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052011",
            "telephone_number": "662-244-2288",
            "fax_number": "662-244-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "EDWARD",
        "middle_name": "FRANK",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MS",
            "license": "17871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05082097",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AL",
            "identifier": "731-04786",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mitchell Ray Crane, DMD
• Creative Health Solutions
• Mary Grace Crenshaw, COTA/L
• Sarah G Crigler, MS, LPC
• Marcus Crittenden, MD
• Tyronda Crowell
• Sherrill Ann Culpepper, LPN
• Susanne Stumpf Cunningham, O.D.
• Robert Hugh Curry
• Curtis Optometry Clinic and Dispensary, P. a.

• All providers in Columbus, MS
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.