Active NPI
Jillian M Crossgrove, BSM, CPM, LDM
- Midwife
- Carlton, OR
National Provider Identifier
1811676554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- DEM-LD-10226745
- Practice address
- 620 N 1St St
Carlton, OR 97111-9642 - Phone
- (904) 599-9691
- NPI assigned
- Jul 11, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | DEM-LD-10226745 | OR | Primary |
Addresses
Primary practice location
620 N 1St St
Carlton, OR 97111-9642
Mailing address
620 N 1St St
Carlton, OR 97111-9642
Phone (904) 599-9691
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEM-LD-10226745 | OR | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771372800000",
"number": "1811676554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 N 1ST ST",
"city": "CARLTON",
"state": "OR",
"postal_code": "971119642",
"telephone_number": "904-599-9691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 N 1ST ST",
"city": "CARLTON",
"state": "OR",
"postal_code": "971119642",
"telephone_number": "904-599-9691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROSSGROVE",
"first_name": "JILLIAN",
"middle_name": "M",
"credential": "BSM, CPM, LDM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-11",
"last_updated": "2026-02-18",
"certification_date": "2026-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Midwife",
"state": "OR",
"license": "DEM-LD-10226745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carlton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.