JASON ROBERT CROCKETT (NPI# 1497995245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497995245 |
| Entity Type | Individual |
| Full Name | JASON ROBERT CROCKETT |
| Credential | PA-C |
| Practice Address |
7431 Nw Loop 410 Ste 109 San Antonio TX 78245-3597 |
| Mailing Address |
2961 Mossrock San Antonio TX 78230-5119 |
| Practice Telephone | 2104777190 |
| Practice Fax Number | 2104777195 |
| Mailing Telephone | 2107314800 |
| Mailing Fax Number | 2107314810 |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2020-04-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA08628 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | WELLMED MEDICARE | 484297YPLS | 01 |
| TX | WELLMED MEDICAID | 3560419-01 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6157 Nw Loop 410, 124, San Antonio, TX 78238 | 2105231411 | 2105239307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821075375 | Jason Mitchell Crockett | Chiropractor | 733 W Kearney St, Springfield, MO 65803-1229 | 2005-12-27 |
| 1922543131 | Jason Wesley Crockett | Registered Nurse | 20 Duke Medicine Circle Duke Cancer Center Clinic 5-1, Durham, NC 27710 | 2016-12-23 |
| 1932300308 | Jason E Crockett | Optometrist | 1800 Old Lebanon Rd, Campbellsville, KY 42718-9663 | 2007-05-31 |
| Street Address |
7431 NW LOOP 410 STE 109 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78245-3597 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043201932 | Charles Allen Proulx | Physician Assistant | 7431 Nw Loop 410 Ste 109, San Antonio, TX 78245-3597 | 2005-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912510082 | Ab Solutions LLC | Community/Behavioral Health | 9439 Dugas, San Antonio, TX 78245 | 2020-08-28 |
| 1871113522 | Sharnell Jayana Garza | Licensed Vocational Nurse | 10248 Harora Field, San Antonio, TX 78245 | 2020-04-23 |
| 1003444282 | Rose Bechebuh | Licensed Vocational Nurse | 10766 Gemsbcuk Lodge, San Antonio, TX 78245 | 2020-04-01 |
| 1538700729 | Sng - Westover Hills Dialysis Clinic | Clinic/Center | 9443 Dugas Dr, San Antonio, TX 78245 | 2019-09-30 |
| 1578023974 | Daniel Max & Marcandrea LLC | Optometrist | 8539 Tx 151, San Antonio, TX 78245 | 2019-03-21 |
| 1487112991 | San Antonio Family Dental Pllc | Dentist | 14249 Potranco Road, Ste 104, San Antonio, TX 78245 | 2019-03-05 |
| 1750851333 | Traci Rae L'ecuyer | Student in an Organized Health Care Education/Training Program | 2314 Hornsby Bend, San Antonio, TX 78245 | 2018-11-27 |
| 1992287783 | Leticia Flores | Occupational Therapy Assistant | 8707 Lakeside Parkway, San Antonio, TX 78245 | 2018-08-29 |
| 1649763517 | Four Winds Hospice, Inc | Hospice Care, Community Based | 12703 Coal Mine Rise, San Antonio, TX 78245 | 2018-06-14 |
| 1982106696 | Marbach Smiles Pllc | Dentist | 10910 Marbach Road, San Antonio, TX 78245 | 2018-03-08 |
| Find all providers in zip 78245 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447866298 | Diana P Olivares | Physician Assistant | 8920 Quihi Way, San Antonio, TX 78254-1901 | 2020-09-17 |
| 1740893445 | Mcrm Assist, Pllc | Physician Assistant | 14546 Brook Hollow Blvd # 417, San Antonio, TX 78232-3810 | 2020-08-24 |
| 1508476086 | Matthew Gaines | Physician Assistant | 2626 Bluff Xing, San Antonio, TX 78244-1000 | 2020-08-09 |
| 1235757519 | Joseph Dominic Wechsler Jr. | Physician Assistant | 9114 Autumn Skies, San Antonio, TX 78254-1929 | 2020-07-13 |
| 1396368015 | Maureen Genov | Physician Assistant | 540 Madison Oak Dr Ste 450, San Antonio, TX 78258-3932 | 2020-05-28 |
| 1386266062 | Sun Assist, Pllc | Physician Assistant | 10650 Culebra Rd # 104-484, San Antonio, TX 78251-4949 | 2020-05-15 |
| 1134758964 | Mark Lee Nentwig | Physician Assistant | 1434 E Sonterra Blvd Ste 206, San Antonio, TX 78258-4973 | 2020-04-03 |
| 1962034694 | Christina L Russell | Physician Assistant | 525 Oak Centre Dr Ste 100, San Antonio, TX 78258-3916 | 2020-02-11 |
| 1265071203 | Caralyne Sandquist | Physician Assistant | 5510 Presidio Parkway, Building #2 Suite 2401, San Antonio, TX 78249 | 2019-12-21 |
| 1447808498 | Elizabeth Ann Blair | Physician Assistant | 24623 Birdie Rdg, San Antonio, TX 78260-7847 | 2019-09-03 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78245 |
Please comment or provide details below to improve the information on JASON ROBERT CROCKETT.
| 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.