Individual provider Active NPI

Jennifer Joy Crooks, FNP-BC

  • Nurse Practitioner
  • Brookhaven, GA
National Provider Identifier
1780281477
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN238307 Issued in GA
Practice address
2154 Johnson Ferry Rd NE
Brookhaven, GA 30319-2558
Phone
(678) 732-1500
NPI assigned
Oct 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3-000112 AL
Nurse Practitioner 363L00000X RN238307 GA Primary

Addresses

Primary practice location

2154 Johnson Ferry Rd NE
Brookhaven, GA 30319-2558

Mailing address

195 Hamilton Mulberry Grove Rd
Cataula, GA 31804-2503

Other practice location 1

307 Church St
LaGrange, GA 30240-2700
Phone (706) 580-5997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211012001539 AL Practitioner - Nurse Practitioner 4587062138 Reassigns benefits to 1 organization
I20250604001766 GA Practitioner - Nurse Practitioner 4587062138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

2154 Johnson Ferry Rd NE
Brookhaven, GA 30319-2558
Phone (678) 732-1509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3-000112ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stopwatch Urgent Care Centers LLC CurrentSince May 20, 2025 Accepting new patients
Piedmont Professional Services, LLC Family Medicine CurrentSince May 27, 2025 Accepting new patients
Piedmont Medical Care Corporation Family Medicine Past Accepting new patients

Locations

2415 Moores Mill Rd
Unit 230
Auburn, AL 36830
Phone (334) 502-1117

3838 US Highway 80 W
Phenix City, AL 36870
Phone (334) 502-1117

2154 Johnson Ferry Rd NE
Brookhaven, GA 30319
Phone (678) 732-1509

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1780281477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 HAMILTON MULBERRY GROVE RD",
            "city": "CATAULA",
            "state": "GA",
            "postal_code": "318042503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 JOHNSON FERRY RD NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303192558",
            "telephone_number": "678-732-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "307 Church St",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "GA",
            "postal_code": "302402700",
            "country_code": "US",
            "telephone_number": "706-580-5997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROOKS",
        "first_name": "JENNIFER",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "3-000112",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN238307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

Verify at the official NPI Registry.