JUSTIN MICHAEL CROFT (NPI# 1770835522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770835522 |
| Entity Type | Individual |
| Full Name | JUSTIN MICHAEL CROFT |
| Credential | PA-C |
| Practice Address |
1348 Walton Way Ste 5700 Augusta GA 30901-5110 |
| Mailing Address |
Po Box 1705 Augusta GA 30903-1705 |
| Practice Telephone | 7067747263 |
| Practice Fax Number | 7067747230 |
| Mailing Telephone | (706) 774-7263 |
| Mailing Fax Number | 7067747230 |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2017-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
008321 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 1647PA | 05 |
| Street Address |
1348 WALTON WAY STE 5700 |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30901-5110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255321915 | Anthony Dhiantie Goei | Radiology | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2005-10-25 |
| 1831754738 | Jennifer T Reid | Nurse Practitioner | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2019-05-06 |
| 1477090900 | Renee Fritz | Physician Assistant | 1348 Walton Way Ste 5700, Augusta, GA 30901 | 2017-01-23 |
| 1952765018 | Rebekah Scout Sanders | Nurse Practitioner | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2016-04-05 |
| 1649534314 | Julyn Kendra Burton | Nurse Practitioner | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2012-06-27 |
| 1780944538 | Tamara Lynn Wyscaver Dirven | Nurse Practitioner | 1348 Walton Way Ste 5700, Augusta, GA 30901 | 2012-05-25 |
| 1154579605 | Christopher Ellington | Surgery | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2008-09-08 |
| 1407036585 | Bradley Earnest Carr | Technician, Other | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2007-11-06 |
| 1609815729 | William Clifford Kitchens | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2006-06-05 |
| 1285691113 | John Salvatore Anastasi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1348 Walton Way Ste 5700, Augusta, GA 30901 | 2006-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477019925 | Courtney Erin Fairchild | Physician Assistant | 1101 15th Street, Pa-224, Augusta, GA 30901 | 2019-02-20 |
| 1699263921 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1022 Walton Way Spc C, Augusta, GA 30901 | 2018-04-23 |
| 1235684192 | Heather Raborn | Allergy & Immunology | 1350 Walton Way Ste 5100, Augusta, GA 30901 | 2016-08-22 |
| 1457690745 | Rehab Without Walls, Inc. | In Home Supportive Care | 820 St Sebastin Way Se, Augusta, GA 30901 | 2013-02-06 |
| 1861788051 | Christina Weidner Belcher | Physical Therapist | 1246 Pine St, Augusta, GA 30901 | 2011-06-25 |
| 1750695979 | C H Martin Company | Durable Medical Equipment & Medical Supplies | 1456 Walton Way Suite B, Augusta, GA 30901 | 2010-07-29 |
| 1366773905 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4027 Wheeler Rd, Augusta, GA 30901 | 2010-01-21 |
| 1851622484 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1715 Forest Drive, Augusta, GA 30901 | 2010-01-21 |
| 1760615280 | Absolute Family PCh | Point of Service | 2035 Old Savannah Rd., Augusta, GA 30901 | 2009-09-01 |
| 1073740643 | Ryan J Altenburg | Internal Medicine | 820 Saint Sebastian Way Ste 8a, Augusta, GA 30901 | 2009-06-22 |
| Find all providers in zip 30901 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710528401 | Hannah Ingrid Boomgarden | Physician Assistant | 1467 Harper Street Hb 5040, Augusta, GA 30912-5775 | 2019-10-03 |
| 1053498519 | Charles P Bean | Physician Assistant | 818 Saint Sebastian Way Ste 403, Augusta, GA 30901-2654 | 2006-11-01 |
| 1891703633 | Stephen W Thompson | Physician Assistant | 1003 Chafee Ave, Augusta, GA 30904-5867 | 2006-08-04 |
| 1194363119 | Kinya Warren | Physician Assistant | 950 15th St, Augusta, GA 30901-2608 | 2019-12-20 |
| 1801307384 | Molly Nadeau | Physician Assistant | 15 Enterprise Dr, Augusta, ME 04330-7997 | 2017-10-24 |
| 1477090900 | Renee Fritz | Physician Assistant | 1348 Walton Way Ste 5700, Augusta, GA 30901 | 2017-01-23 |
| 1750833729 | Kathleen Devan Early | Physician Assistant | 3650 J Dewey Gray Cir, Augusta, GA 30909-1867 | 2016-10-26 |
| 1427505940 | Kit Taylor | Physician Assistant | 840 Stevens Creek Rd, Augusta, GA 30907-9251 | 2016-09-01 |
| 1912389347 | Eric Daniels | Physician Assistant | 15 Enterprise Dr, Augusta, ME 04330-7997 | 2015-06-22 |
| 1194159111 | Marc Leduc | Physician Assistant | 1120 15th St, Suite Bp 4134, Augusta, GA 30912-0004 | 2013-08-27 |
| Find all providers in AUGUSTA | ||||
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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.