Jodi Lynn Crockett, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1288 Issued in ND

Practice address

2401 41St St S
Fargo, ND 58104-7783

Phone

(701) 478-7868

NPI assigned

Sep 14, 2006

Last updated

Mar 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Rehabilitation Center IncGroup PAC ID 5193784080, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Professional Rehabilitation Center Inc

  dba Pro Rehab Center, Inc

  • Physical Therapist
  • Fargo, ND
  • NPI 1215014105
  Medicare reassignment Care Compare group NPD
• Big Stone Therapies Fargo, Inc

  • Physical Therapy Clinic/Center
  • Fargo, ND
  • NPI 1194021873

  Physical Therapist

  Medicare reassignment NPD
• Professional Rehabilitation Center Inc

  dba Pro Rehab Center, Inc

  • Physical Therapist
  • Fargo, ND
  • NPI 1164753737
  NPD
• Med-Plus Health Care, PLLC

  dba Foss Spine and Wellness

  • Chiropractor
  • Moorhead, MN
  • NPI 1114028503

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1992800551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CROSS ST",
            "city": "BIG STONE CITY",
            "state": "SD",
            "postal_code": "572168237",
            "telephone_number": "605-541-1140",
            "fax_number": "218-233-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 41ST ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047783",
            "telephone_number": "701-478-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "JODI",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "6503",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318295900",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55086",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colena Jane Critelli, CRPT
• Shawna Marie Croaker, LCSW
• Nicholas Crocker, MSW
• Suzanne Crocker
• Tina Crocker
• Dawn Michelle Cronin, ICGC, LBSW
• James Daniel Cronin, LCSW, LICSW
• Cheri B Cross, NP
• Jennifer Cross
• Morgan Arzelle Croves, NP

• Physical Therapist in Fargo, ND
• Providers in Fargo, ND by specialty
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.