DR. JONATHAN JAMES CROUSE, D.C. - NPI NUMBER 1609095785

Summary

Provider Name: DR. JONATHAN JAMES CROUSE, D.C.

NPI Number: 1609095785

Clasification: Chiropractor (111N00000X)

Address:
8478 RTE 949
SIGEL, PA
ZIP 15860

Phone Number: (814) 752-2218



Detailed Information

DR. Jonathan James Crouse, D.C. is a chiropractor in Sigel, PA. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. The assigned NPI number for this provider is 1609095785 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

8478 RTE 949
SIGEL, PA
ZIP 15860
Phone: (814) 752-2218
Fax: (814) 752-2218

The enumeration date for this NPI number is 4/25/2007 and was last updated on 7/8/2007.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 111N00000X Chiropractor DC008800 PA X
2 111NR0400X Chiropractor Rehabilitation AJ008669 PA X

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 1690585 OTHER PA HIGHMARK BLUE CROSS BLUE

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1609095785 The date that a record was last updated or changed.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name CROUSE The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name JONATHAN The first name of the provider, if the provider is an individual.
5 Provider Middle Name JAMES The middle name of the provider, if the provider is an individual.
6 Provider Name Prefix Text DR. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
7 Provider Credential Text D.C. The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
8 Provider First Line Business Practice Location Address 8478 RTE 949 The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Business Practice Location Address City Name SIGEL The city name in the location address of the provider being identified.
10 Provider Business Practice Location Address State Name PA The State code in the location of the provider being identified.
11 Provider Business Practice Location Address Postal Code 15860 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
12 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
13 Provider Business Practice Location Address Telephone Number 8147522218 The telephone number associated with the location address of the provider being identified.
14 Provider Business Practice Location Address Fax Number 8147522218 The fax number associated with the location address of the provider being identified.
15 Provider Enumeration Date 4/25/2007 The date the provider was assigned a unique identifier (assigned an NPI).
16 Last Update Date 7/8/2007 The date that a record was last updated or changed.
17 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
18 Healthcare Provider Taxonomy Code 1 111N00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Provider License Number 1 DC008800 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
20 Provider License Number State Code 1 PA The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
21 Healthcare Provider Primary Taxonomy Switch 1 X
22 Healthcare Provider Taxonomy Code 2 111NR0400X
23 Provider License Number 2 AJ008669 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
24 Provider License Number State Code 2 PA The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
25 Healthcare Provider Primary Taxonomy Switch 2 X
26 Other Provider Identifier 1 1690585 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier Type Code 1 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
28 Other Provider Identifier State 1 PA
29 Other Provider Identifier Issuer 1 HIGHMARK BLUE CROSS BLUE
30 Is Sole Proprietor Y Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No


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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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