MR. JACE JOHN CRAWFORD (NPI# 1174065411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174065411 |
| Entity Type | Individual |
| Full Name | MR. JACE JOHN CRAWFORD |
| Credential | PA-C |
| Practice Address |
5126 Hospital Dr Ne Covington GA 30014-2566 |
| Practice Telephone | 7707867053 |
| Mailing Telephone | 7707867053 |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2016-11-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5126 HOSPITAL DR NE |
| City | COVINGTON |
| State | GA |
| Zip Code | 30014-2566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831196682 | Daniel T Riley | Internal Medicine | 5126 Hospital Dr Ne, Covington, GA 30014-2566 | 2005-07-07 |
| 1306445069 | Marlee Malcom | Registered Nurse | 5126 Hospital Dr Ne, Covington, GA 30014-2566 | 2020-10-22 |
| 1487292694 | Stella Royette Thomas | Registered Nurse | 5126 Hospital Dr Ne, Covington, GA 30014-2566 | 2019-12-18 |
| 1013550177 | Anish Joseph | Anesthesiologist Assistant | 5126 Hospital Dr Ne, Covington, GA 30014-2566 | 2019-10-22 |
| 1255891958 | Piedmont Newton Ekg Billing LLC | General Acute Care Hospital | 5126 Hospital Dr Ne, Covington, GA 30014-2566 | 2019-03-20 |
| 1538639851 | Mary Kathryn Ward | Nurse Practitioner | 5126 Hospital Dr Ne, Covington, GA 30014-2566 | 2018-11-29 |
| 1063981082 | Jamie Michelle Huff | Nurse Practitioner | 5126 Hospital Dr Ne, Covington, GA 30014-2566 | 2018-11-20 |
| 1013360932 | Hoda Daher | Internal Medicine | 5126 Hospital Dr Ne, Covington, GA 30014-2566 | 2016-07-15 |
| 1063864445 | Sakina Peregrino-brimah | Internal Medicine | 5126 Hospital Dr Ne, Covington, GA 30014-2566 | 2016-07-08 |
| 1659722601 | Jonathan Altman | Emergency Medicine | 5126 Hospital Dr Ne, Covington, GA 30014-2566 | 2016-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495635 | Cathy Cassandra Collins | Pharmacist | 3639 Hwy 278, Covington, GA 30014 | 2020-10-22 |
| 1154933877 | Atl Optical LLC | Optometrist | 3135 Highway 278 Ne, Covington, GA 30014 | 2020-08-24 |
| 1932737046 | Samagas House Org | Adult Companion | 1500 Mountain View Cirlcle, Conyers, GA 30014 | 2020-04-01 |
| 1356834360 | Covington Dental Care | Dentist | 4139 Baker Street, Suite 15, Covington, GA 30014 | 2018-06-13 |
| 1487190005 | New Avenues Assessment and Counseling Center LLC | Counselor | 3192 Spring Street, Covington, NEWTON 30014 | 2017-01-07 |
| 1275903973 | Jennifer Carol Bridges | Registered Nurse | 320 Malcom Lane, Covington, GA 30014 | 2015-10-07 |
| 1134598501 | Shelby Boggus King | Physician Assistant | 4181 Hospital Drive Ne, Suite 204, Covington, GA 30014 | 2015-09-16 |
| 1366829814 | Wendy Pazdur | Counselor | 5109 Hwy 278 East, Suite D, Covington, GA 30014 | 2015-05-05 |
| 1306235445 | Covington Center for Family Dentistry | Dentist | 10373 Industrial Blvd, Covington, GA 30014 | 2015-01-13 |
| 1992103428 | Modern Cosmetic Dental Care, LLC | Clinic/Center | 1750 Highway 11, Suite B, Covington, GA 30014 | 2014-12-16 |
| Find all providers in zip 30014 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356797658 | Courtney Coyle | Physician Assistant | 1980 N Hwy, Covington, LA 70433-5158 | 2016-05-05 |
| 1477925196 | Sydney F Fussell | Physician Assistant | 1203 S Tyler St Ste 100, Covington, LA 70433-2353 | 2015-10-21 |
| 1134598501 | Shelby Boggus King | Physician Assistant | 4181 Hospital Drive Ne, Suite 204, Covington, GA 30014 | 2015-09-16 |
| 1598929630 | Yormica L Truitt | Physician Assistant | 1775 Access Rd Ste C, Covington, GA 30014-1987 | 2008-07-17 |
| 1407337611 | Sarah Beth Marx | Physician Assistant | 1000 Ochsner Blvd, Covington, LA 70433-8107 | 2018-08-25 |
| 1720331333 | Allison B Jung | Physician Assistant | 360 Emerald Forest Blvd, Ste H, Covington, LA 70433-5193 | 2012-10-19 |
| 1063784676 | Charles W Holloway | Physician Assistant | 1775 Access Rd Ste C, Covington, GA 30014-1987 | 2012-01-30 |
| 1386948891 | Eric James Boyer | Physician Assistant | 1995 Highway 51 S, Covington, TN 38019-3635 | 2010-12-28 |
| 1396980215 | Tatyana A. Storozhuk | Physician Assistant | 27500 168th Pl Se, Covington, WA 98042-5563 | 2008-12-05 |
| 1699781799 | Erin K Rogers Marckel | Physician Assistant | 16850 Se 272nd St, Covington, WA 98042-4931 | 2006-07-31 |
| Find all providers in COVINGTON | ||||
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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.