DR. DEIDRE DENISE CROCKER (NPI# 1790947117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790947117 |
| Entity Type | Individual |
| Full Name | DR. DEIDRE DENISE CROCKER |
| Credential | MD |
| Practice Address |
2390 Wall St Se Conyers GA 30013-2150 |
| Practice Telephone | 7709225696 |
| Practice Fax Number | 7709221065 |
| Mailing Telephone | 7709225696 |
| Mailing Fax Number | 7709221065 |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2011-11-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207K00000X | Allergy & Immunology | 056811 | GA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 056811 | GA | Allopathic & Osteopathic Physicians |
| N | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
056811 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
2390 WALL ST SE |
| City | CONYERS |
| State | GA |
| Zip Code | 30013-2150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689614885 | Robert Martin Cohen | Internal Medicine | 2390 Wall St Se, Conyers, GA 30013-2186 | 2006-06-07 |
| 1467671305 | The Allergy & Asthma Center, LLC | Allergy & Immunology | 2390 Wall St Se, Conyers, GA 30013-2186 | 2007-04-25 |
| 1942350533 | Spelios and Associates Conyers PC | Point of Service | 2390 Wall St Se, Suite 120, Conyers, GA 30013-2186 | 2007-01-12 |
| 1558303875 | Jon E Stahlman | Allergy & Immunology | 2390 Wall St Se, Conyers, GA 30013-2186 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144842295 | Fit Therapy, LLC | Physical Therapist | 2008 Eastview Parkway, Suite 150, Conyers, GA 30013 | 2020-05-12 |
| 1144854753 | Atl Optical LLC | Optometrist | 1285 Ga 138, Conyers, GA 30013 | 2020-02-24 |
| 1386201820 | Achundris P Taylor | Social Worker | Harvest Grove Lane, Conyers, GA 30013 | 2019-05-21 |
| 1588153381 | Curbside Medical Transporters | Ambulance | 2404 Brynlyn Woods Dr Ne, Conyers, GA 30013 | 2018-05-07 |
| 1184124877 | Nursing Companion, LLC | Homemaker | 1064 Duke Dr, Conyers, GA 30013 | 2018-02-19 |
| 1588163638 | Atlanta Plus Urgent Care | Clinic/Center | 2121 Salem Rd. Se, Conyers, GA 30013 | 2018-02-05 |
| 1043735244 | Niki Tanyell Davis | Licensed Practical Nurse | 1403 Windy Hill Court, Conyers, GA 30013 | 2017-08-08 |
| 1063941490 | Comprehensive Health and Rehab LLC | Clinic/Center | 2500 Riverton Drive, Conyers, GA 30013 | 2017-06-08 |
| 1306373188 | Graceol Corporation | Family Medicine | 1035 Honey Creek Rd, Conyers, GA 30013 | 2017-05-11 |
| 1881149268 | Jsa Dental Associates Conyers PC | Dentist | 1151 Nor Tec Dr, Suite B, Conyers, GA 30013 | 2016-08-16 |
| Find all providers in zip 30013 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467671305 | The Allergy & Asthma Center, LLC | Allergy & Immunology | 2390 Wall St Se, Conyers, GA 30013-2186 | 2007-04-25 |
| 1558303875 | Jon E Stahlman | Allergy & Immunology | 2390 Wall St Se, Conyers, GA 30013-2186 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935411 | St. Mary's Medical Group, Inc. | Allergy & Immunology | 1360 Caduceus Way Bldg 200-102, Watkinsville, GA 30677-7349 | 2020-06-02 |
| 1750902185 | Center for Allergy and Asthma Southern Crescent | Allergy & Immunology | 1975 Highway 54 W Ste 255, Peachtree City, GA 30269-4794 | 2020-04-27 |
| 1003472036 | Annual Wellness Centers of America | Allergy & Immunology | 753 Old Norcross Rd Ste B, Lawrenceville, GA 30046-4312 | 2019-05-15 |
| 1821567371 | Breathe Better Allergy Asthma & Sinus Center, Inc | Allergy & Immunology | 950 S Enota Dr Ne Ste A, Gainesville, GA 30501-2439 | 2018-11-14 |
| 1982111316 | Sofia Miriam Sheikh | Allergy & Immunology | 4003 Oak Forest Dr Ne, Marietta, GA 30062-8022 | 2018-01-08 |
| 1366969560 | Allergy Consulting Group, LLC | Allergy & Immunology | 5752b Buford Hwy Ne, Doraville, GA 30340-1207 | 2017-08-28 |
| 1235684192 | Heather Raborn | Allergy & Immunology | 1350 Walton Way Ste 5100, Augusta, GA 30901 | 2016-08-22 |
| 1730597196 | Allergy Testing Solutions, LLC | Allergy & Immunology | 789 Hammond Dr, Unit 2510, Sandy Springs, GA 30328-8161 | 2014-07-30 |
| 1164863999 | Chih-yin Yeh | Allergy & Immunology | 5673 Peachtree Dunwoody Rd # 445, Atlanta, GA 30342-1731 | 2013-07-09 |
| 1023352069 | Advanced Allergy Inc | Allergy & Immunology | 5512 Glenridge Dr Ne, Unit A, Atlanta, GA 30342-7213 | 2012-11-15 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. DEIDRE DENISE CROCKER.
| 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.