Nicole Casimira Crane, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5770 Issued in GA

Practice address

303 Smith St
Lagrange, GA 30240-2745

Phone

(706) 812-4381

Fax

(706) 812-4032

NPI assigned

Feb 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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 1

Specialty

Physician Assistant

Education

Medical College of Georgia School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hometown Physician Group, LLCGroup PAC ID 1759678824, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar West Georgia Medical Center Hospital, Lagrange, GA, CCN 110016

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Hometown Physician Group, LLC

  • Family Medicine Physician
  • Lagrange, GA
  • NPI 1992153548
  Medicare reassignment Care Compare group
• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• West Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Lagrange, GA
  • NPI 1821221144
  Care Compare affiliation

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

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1861724221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 SMITH ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402745",
            "telephone_number": "706-812-4381",
            "fax_number": "706-812-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 SMITH ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402745",
            "telephone_number": "706-812-4381",
            "fax_number": "706-812-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANE",
        "first_name": "NICOLE",
        "middle_name": "CASIMIRA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-09",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "5770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Countryside Hospice Care, Inc
• Covenant Counsel, LLC
• Rebecca Noel Covin, BS, RBT
• Shanterrika L Cox
• Kylia Butler Crane, RD, LD
• Crossroads Treatment Center of Lagrange, PC
• Crouch Chiropractic Clinic
• Eric Alvin Crouch, DC
• Brittain Skylar Crowe
• Deborah Belinda Culpepper

• Medical Physician Assistant in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.