DR. ROBERT LEON CROCKER M.D. NPI 1356580542

NPI Record

The following NPI record includes the field values provided by the NPPES as well as the field definition as published in the Federal Register. The complete NPI record is also available for download in text, csv and xml formats.

Field Name Field Value Definition 1
NPI 1356580542 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
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).
Provider Last Name Legal Name CROCKER The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name ROBERT The first name of the provider, if the provider is an individual.
Provider Middle Name LEON The middle name of the provider, if the provider is an individual.
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.
Provider Credential Text M.D. 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.
Provider First Line Business Practice Location Address 4264 E RIDGE DR 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.
Provider Business Practice Location Address City Name JACKSON The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name MS The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code 392116100 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 6014219177 The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date 2/11/2009 The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 2/11/2009 The date that a record was last updated or changed.
Provider Gender Code M The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1 207Q00000X 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.
Provider License Number 1 08720 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’’.
Provider License Number State Code 1 MS 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.
Healthcare Provider Primary Taxonomy Switch 1 Y
Healthcare Provider Taxonomy Code 2 207Q00000X
Provider License Number 2 118044 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’’.
Provider License Number State Code 2 MO 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.
Healthcare Provider Primary Taxonomy Switch 2 N
Healthcare Provider Taxonomy Code 3 207Q00000X
Provider License Number 3 36653 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’’.
Provider License Number State Code 3 KY 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.
Healthcare Provider Primary Taxonomy Switch 3 N
Healthcare Provider Taxonomy Code 4 207Q00000X
Provider License Number 4 11849 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’’.
Provider License Number State Code 4 HI 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.
Healthcare Provider Primary Taxonomy Switch 4 N
Healthcare Provider Taxonomy Code 5 207Q00000X
Provider License Number 5 9902 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’’.
Provider License Number State Code 5 MT 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.
Healthcare Provider Primary Taxonomy Switch 5 N
Healthcare Provider Taxonomy Code 6 207Q00000X
Provider License Number 6 C1-0006033
Provider License Number State Code 6 DE
Healthcare Provider Primary Taxonomy Switch 6 N
Healthcare Provider Taxonomy Code 7 207Q00000X
Provider License Number 7 040080
Provider License Number State Code 7 CT
Healthcare Provider Primary Taxonomy Switch 7 N
Healthcare Provider Taxonomy Code 8 207Q00000X
Provider License Number 8 A70404
Provider License Number State Code 8 CA
Healthcare Provider Primary Taxonomy Switch 8 N
Healthcare Provider Taxonomy Code 9 207Q00000X
Provider License Number 9 042-0010301
Provider License Number State Code 9 VT
Healthcare Provider Primary Taxonomy Switch 9 N
Healthcare Provider Taxonomy Code 10 207Q00000X
Provider License Number 10 MD12756
Provider License Number State Code 10 TN
Healthcare Provider Primary Taxonomy Switch 10 N
Healthcare Provider Taxonomy Code 11 207Q00000X
Provider License Number 11 22710
Provider License Number State Code 11 OK
Healthcare Provider Primary Taxonomy Switch 11 N
Healthcare Provider Taxonomy Code 12 207Q00000X
Provider License Number 12 8386
Provider License Number State Code 12 ND
Healthcare Provider Primary Taxonomy Switch 12 N
Healthcare Provider Taxonomy Code 13 207Q00000X
Provider License Number 13 200001571
Provider License Number State Code 13 NC
Healthcare Provider Primary Taxonomy Switch 13 N
Healthcare Provider Taxonomy Code 14 207Q00000X
Provider License Number 14 25MA07091200
Provider License Number State Code 14 NJ
Healthcare Provider Primary Taxonomy Switch 14 N
Healthcare Provider Taxonomy Code 15 207Q00000X
Provider License Number 15 11127
Provider License Number State Code 15 NH
Healthcare Provider Primary Taxonomy Switch 15 N
Is Sole Proprietor Y Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

(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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What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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