JACK R CROWDER (NPI# 1447214382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447214382 |
| Entity Type | Individual |
| Full Name | JACK R CROWDER |
| Credential | M.D. |
| Practice Address |
2002 Brookside Dr Suite 300 Kingsport TN 37660-4634 |
| Practice Telephone | 4233926370 |
| Practice Fax Number | 4233926736 |
| Mailing Telephone | 4233926370 |
| Mailing Fax Number | 4233926736 |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2010-08-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | MD07408 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | JOHN DEERE | TN01L6 | 01 |
| TN | BCBS | 2005847 | 01 |
| TN | 3160026 | 05 |
| Street Address |
2002 BROOKSIDE DR SUITE 300 |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841293560 | Nicole M Miller | Pediatrics | 2002 Brookside Dr, Suite 200, Kingsport, TN 37660-4634 | 2005-05-27 |
| 1649641200 | Sam W. Huddleston Iv Md PC | Specialist | 2002 Brookside Dr, Suite# 201, Kingsport, TN 37660-4634 | 2015-10-08 |
| 1487050233 | Natasha Benfield Gouge | Psychologist | 2002 Brookside Dr, Suite 200, Kingsport, TN 37660-4634 | 2014-11-06 |
| 1992105431 | Bblue Ridge Medical Management Corporation | Pediatrics | 2002 Brookside Dr, Suite 200, Kingsport, TN 37660-4634 | 2014-09-03 |
| 1659706208 | Ashley H Begley | Nurse Practitioner | 2002 Brookside Dr, Kingsport, TN 37660-4634 | 2013-09-13 |
| 1346686763 | Blue Ridge Medical Management Corporation | Specialist | 2002 Brookside Dr, Suite 300a, Kingsport, TN 37660-4634 | 2013-05-13 |
| 1538378005 | Janice Louise Yeager | Registered Nurse | 2002 Brookside Dr, Suite 300, Kingsport, TN 37660-4634 | 2007-05-22 |
| 1639210222 | Sathiyendran Poobalasingham | Internal Medicine | 2002 Brookside Dr, Suite 102, Kingsport, TN 37660-4634 | 2007-02-08 |
| 1902918717 | Bio-medical Applications of Tennessee, Inc. | Clinic/Center | 2002 Brookside Dr, Suite 101, Kingsport, TN 37660-4634 | 2006-08-31 |
| 1659382885 | Blue Ridge Medical Management Corporation | Obstetrics & Gynecology | 2002 Brookside Dr, Suite 200, Kingsport, TN 37660-4634 | 2006-08-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| Find all providers in zip 37660 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740585710 | Abraham Isaac Sobel | Obstetrics & Gynecology | 412 High Ridge Rd, Kingsport, TN 37660-3419 | 2011-01-21 |
| 1730143801 | Paul R Kramer | Obstetrics & Gynecology | 6 Sheridan Sq, Suite 100, Kingsport, TN 37660-7390 | 2006-04-14 |
| 1780648972 | Donald R Lovelace | Obstetrics & Gynecology | 2002 Brookside Dr Ste 300, Kingsport, TN 37660-4634 | 2006-04-14 |
| 1407834211 | Chadi Milad Jarjoura | Obstetrics & Gynecology | 105 W Park Dr, Kingsport, TN 37660-3805 | 2006-01-03 |
| 1205831567 | Judith P. Fischer | Obstetrics & Gynecology | One Sheridan Square, Suite 105, Kingsport, TN 37660 | 2005-06-14 |
| 1649697905 | Whitney Rich | Obstetrics & Gynecology | 2002 Brookside Dr Ste 300, Kingsport, TN 37660-4634 | 2014-03-25 |
| 1104185065 | Rebecca A Krzyminski | Obstetrics & Gynecology | 105 W Stone Dr, Ste 2b, Kingsport, TN 37660-3365 | 2012-05-14 |
| 1659382885 | Blue Ridge Medical Management Corporation | Obstetrics & Gynecology | 2002 Brookside Dr, Suite 200, Kingsport, TN 37660-4634 | 2006-08-11 |
| 1548270879 | Blue Ridge Medical Management Corporation | Obstetrics & Gynecology | 2002 Brookside Dr, Ste 300, Kingsport, TN 37660-4634 | 2006-08-09 |
| 1396753471 | Darlene E Fogg | Obstetrics & Gynecology | 2002 Brookside Dr Ste 300, Kingsport, TN 37660-4634 | 2006-08-04 |
| Find all providers in KINGSPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.