Individual provider Active NPI

Jason Crowley, FNP, DC

  • Family Nurse Practitioner
  • South Lake Tahoe, CA
National Provider Identifier
1871862565
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202002222 Issued in OR
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

Updated by the provider on Mar 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 CA2 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
I20121128000650 CA Practitioner - Chiropractic 5597917427 Practice locations: South Lake Tahoe, CA
I20201118001665 CA Practitioner - Nurse Practitioner 5597917427 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
89.85
Promoting interoperability
94.05
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32141CAMDDentist
202002222ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tahoe Carson Valley Medical Group Inc CurrentSince Oct 23, 2020 Accepting new patients
Barton Medical Foundation CurrentSince Jan 1, 2023 Accepting new patients
Barton Healthcare System Past Accepting new patients
Azzolino Chiropractic Neurology & Integrative Wellness, Inc Neurology PastSince Apr 15, 2013 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.