Active NPI
Gwinnett Center Medical Associates
- Primary Care Clinic/Center
- Lawrenceville, GA
National Provider Identifier
1811097181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- License
- 039315
- Legal business name
- GWINNETT CENTER MEDICAL ASSOCIATES
- Practice address
- 748 Old Norcross Rd
Suite 185
Lawrenceville, GA 30045-3393 - Phone
- (770) 277-8554
- Fax
- (770) 277-1799
- NPI assigned
- Sep 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Christopher Scott Crooker, M.D.
- Title
- Owner
- Phone
- (770) 277-8554
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 039315 | GA | Primary |
Addresses
Primary practice location
748 Old Norcross Rd
Suite 185
Lawrenceville, GA 30045-3393
Mailing address
748 Old Norcross Rd
Suite 185
Lawrenceville, GA 30045-3393
Phone (770) 277-8554
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300043932A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031211000151 | GA | Part B Supplier - Clinic/Group Practice | 7810893732 |
Receives reassigned benefits from 5 practitioners Practice locations: Lawrenceville, GA |
National Provider Directory
National Provider DirectoryLocations
748 Old Norcross Rd
Ste 185
Lawrenceville, GA 30046
Phone (770) 277-8554
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- Duluth, GA
- NPI 1417045782
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211932800000",
"number": "1811097181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "748 OLD NORCROSS RD",
"address_2": "SUITE 185",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300453393",
"telephone_number": "770-277-8554",
"fax_number": "770-277-1799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "748 OLD NORCROSS RD",
"address_2": "SUITE 185",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300453393",
"telephone_number": "770-277-8554",
"fax_number": "770-277-1799"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GWINNETT CENTER MEDICAL ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-25",
"last_updated": "2008-05-28",
"status": "A",
"authorized_official_last_name": "CROOKER",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_middle_name": "SCOTT",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "770-277-8554",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "GA",
"license": "039315",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300043932A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.