Active NPI
Jason Crowley, FNP, DC
- Family Nurse Practitioner
- South Lake Tahoe, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 202002222
- Practice address
- 2877 Lake Tahoe Blvd B
South Lake Tahoe, CA 96150-7807 - Phone
- (530) 307-2310
- NPI assigned
- Dec 24, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Chiropractor | 111NN0400X | 32141 | CA | |
| Family Nurse Practitioner | 363LF0000X | 202002222 | OR | Primary |
Addresses
Primary practice location
2877 Lake Tahoe Blvd B
South Lake Tahoe, CA 96150-7807
Mailing address
2877 Lake Tahoe Blvd B
South Lake Tahoe, CA 96150-7807
Phone (530) 307-2310
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 95.71 of 100
- Quality
- 89.85
- Promoting interoperability
- 94.05
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32141 | CA | MD | Dentist |
| 202002222 | OR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tahoe Carson Valley Medical Group Inc | Current | Accepting new patients | |
| Barton Medical Foundation | Current | Accepting new patients | |
| Barton Healthcare System | Past | Accepting new patients | |
| Azzolino Chiropractic Neurology & Integrative Wellness, Inc | Neurology | Past | Accepting new patients |
Locations
1090 3rd St
South Lake Tahoe, CA 96150
Phone (530) 543-5660
2170 South Ave
South Lake Tahoe, CA 96150
Phone (530) 541-3420
2074 Lake Tahoe Blvd
Ste 4
South Lake Tahoe, CA 96150
Phone (530) 543-5554
1108 4th St
South Lake Tahoe, CA 96150
Phone (530) 542-5740
2201 South Ave
South Lake Tahoe, CA 96150
Phone (530) 543-5550
Interoperability endpoints
- jcrowley123886@direct.renown.org
Organizations & group practices 4
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.
-
- Family Medicine Physician
- South Lake Tahoe, CA
- NPI 1750950499
-
- Family Medicine Physician
- South Lake Tahoe, CA
- NPI 1508865528
-
- Neurology Chiropractor
- San Francisco, CA
- NPI 1730223371
-
- Internal Medicine Physician
- South Lake Tahoe, CA
- NPI 1235196015
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584489600000",
"number": "1871862565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2877 LAKE TAHOE BLVD B",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961507807",
"telephone_number": "530-307-2310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2877 LAKE TAHOE BLVD B",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961507807",
"telephone_number": "530-307-2310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROWLEY",
"first_name": "JASON",
"credential": "FNP, DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-24",
"last_updated": "2020-03-18",
"certification_date": "2020-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "111NN0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Neurology",
"state": "CA",
"license": "32141",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "202002222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Lake Tahoe, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; 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.