DR. KELLY CROOKER (NPI# 1801980511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801980511 |
| Entity Type | Individual |
| Full Name | DR. KELLY CROOKER |
| Credential | D.D.S. |
| Practice Address |
950 W Coy Smith Hwy Mount Vernon AL 36560-3201 |
| Mailing Address |
251 N Bayou St Mobile AL 36603-5827 |
| Practice Telephone | 2518299884 |
| Practice Fax Number | 2518299507 |
| Mailing Telephone | 2516908158 |
| Mailing Fax Number | 2515442188 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2011-03-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5653 | AL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 630000013 | 05 | |
| AL | SITE NPI GROUP NUMBER | 1063439065 | 01 |
| AL | MEDICARE GROUP NUMBER | 011846 | 01 |
| Street Address |
950 W COY SMITH HWY |
| City | MOUNT VERNON |
| State | AL |
| Zip Code | 36560-3201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013975788 | Elmo Dodd Ozment Jr. | Internal Medicine | 950 W Coy Smith Hwy, Mount Vernon, AL 36560-3201 | 2006-05-03 |
| 1407119837 | Justin Zackary Jeffus | Dentist | 950 W Coy Smith Hwy, Mount Vernon, AL 36560-3201 | 2012-06-20 |
| 1013245257 | Kaci M Byrd Cheeseman | Physician Assistant | 950 W Coy Smith Hwy, Mount Vernon, AL 36560-3201 | 2009-11-30 |
| 1225111396 | Robert A Cummings | Dentist | 950 W Coy Smith Hwy, Mount Vernon, AL 36560-3201 | 2006-10-23 |
| 1558314385 | Joel D Green | Dentist | 950 W Coy Smith Hwy, Mount Vernon, AL 36560-3201 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255870085 | Truly Pollard | Counselor | 18125 Highway 43, Mount Vernon, AL 36560 | 2017-02-13 |
| 1023293156 | Springhill Physician Practices, Inc | Clinic/Center | 21741 Us Highway 43, Mt Vernon, AL 36560 | 2008-01-08 |
| 1306909569 | Margie M Wiley | Technician, Other | Mt. Vernon Pharmacy, 19390 Hwy 43 & Mildred St., Mt. Vernon, AL 36560 | 2006-12-19 |
| 1841366481 | Mcconaghy Drug Store Inc | Durable Medical Equipment & Medical Supplies | 19390 Hwy 43 and Mildred Street, Mount Vernon, AL 36560 | 2006-11-27 |
| 1972698199 | Mobile County Board of Health | Clinic/Center | 1080 Reservation Rd, Mount Vernon, AL 36560 | 2006-10-04 |
| 1740389543 | Jose M Bolanos | Physician Assistant | 725 E Coy Smith Highway, Mt Vernon, AL 36560 | 2006-09-21 |
| 1427066307 | State of Alabama Dept of Finance | Psychiatric Hospital | 725 East Coy Smith Hwy, Mt Vernon, AL 36560 | 2006-08-04 |
| 1972511855 | Pedro Dejesus Polanco | Psychiatry & Neurology | 725 East Coy Smith Highway, Mt Vernon, AL 36560 | 2006-08-04 |
| 1942792684 | Jessica Amaka Clarke | Nurse Practitioner | 950 East Coy Smith Hwy, Mt. Vernon, AL 36560 | 2018-05-30 |
| 1124211255 | Damon Ann Robinson | Psychologist | 725 East Coy Smith Highway, Mt Vernon, AL 36560 | 2007-08-22 |
| Find all providers in zip 36560 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467003160 | Elevation Dental Studio, Dmd, P.C. | Dentist | 545 Gramatan Ave Unit B, Mount Vernon, NY 10552-2103 | 2019-09-24 |
| 1659927515 | Manogna Deepthi Yakasiri | Dentist | 4201 Broadway St Ste C, Mount Vernon, IL 62864-2282 | 2019-08-15 |
| 1982263463 | Graham Whinery | Dentist | 908 Highway 37, Mount Vernon, TX 75457-4500 | 2019-06-10 |
| 1184197386 | Rockcastle County Hospital, Inc. | Dentist | 75 Newcomb Ave, Mount Vernon, KY 40456-2732 | 2019-01-10 |
| 1346739430 | Broadway Smiles Dental PC | Dentist | 105 Stevens Ave Ste 302, Mount Vernon, NY 10550-2680 | 2018-05-04 |
| 1629468566 | Franklin Dentistry Associates Pa | Dentist | 908 Texas Highway 37, Mount Vernon, TX 75457-4500 | 2015-01-30 |
| 1326387341 | Edly Destine | Dentist | 88 W Lincoln Ave Ste 102, Mount Vernon, NY 10550-1181 | 2013-02-11 |
| 1114262847 | Cross Creek Dental Care - Mount Vernon,llc | Dentist | 214 E Chestnut St, Mount Vernon, OH 43050-3447 | 2012-12-06 |
| 1104142918 | David Keith Uebelhack | Dentist | 803 East Fourth St., Mount Vernon, IN 47620-0673 | 2010-04-19 |
| 1821324112 | Associates In Dentistry LLC | Dentist | 940 W Main St Unit A, Mount Vernon, KY 40456-2518 | 2009-10-21 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 36560 |
Please comment or provide details below to improve the information on DR. KELLY CROOKER.
| 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.