NICOLE CRUMLEY PA-C
NPI 1164122214
Physician Assistant - Medical in Baldwin, GA

Q: What is Nicole Crumley's NPI number?

The NPI number for Nicole Crumley is 1164122214. It was assigned to this individual provider in the NPPES registry on March 7, 2023. The provider is also known as Nicole Bock.

Q: What is Nicole Crumley's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Crumley was last updated on August 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 07, 2023PECOS Enrolled

155 PROFESSIONAL DRIVE, BALDWIN, GA 30511(706) 776-2368(706) 776-2589 Get Directions Write a Review

NPPES record last updated: August 21, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Aug 17, 2023, Jul 26, 2023, Jul 13, 2023 and 2 more (5 updates tracked since 2023).

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About Nicole Crumley Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE CRUMLEY PA-C (NPI 1164122214) is an individual medical provider in Baldwin, Georgia, licensed in Georgia (11755) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and maintains 5 additional practice locations.

NPPES Registry Identity

NPI1164122214

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameNICOLE CRUMLEYCredential: PA-C

Location Address155 PROFESSIONAL DRIVEBaldwin, GA 30511-4000

Mailing AddressPo Box 658Gainesville, GA 30503-0658 · (770) 718-1122 · Fax (770) 533-4786

Phone(706) 776-2368

Fax(706) 776-2589

Sole ProprietorNo

Enumeration DateMarch 7, 2023

Last NPPES UpdateAugust 21, 20255 updates tracked since enumeration

NPPES CertifiedAugust 21, 2025

✔ NPI 1164122214 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in GA · 11755

Also ListedPhysician AssistantTaxonomy 363A00000X · License 11755 (GA)

155 PROFESSIONAL DRIVE, Baldwin, GA 30511

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Other Names 1

Former Name (1)Nicole Bock

Secondary Practice Locations 5

Location 1725 Jesse Jewell Pkwy SEGainesville, GA 30501-3834 · Phone (770) 535-3611 · Fax (770) 535-7092

Location 24019 Executive DriveOakwood, GA 30566-3433 · Phone (770) 533-6500 · Fax (770) 533-6543

Location 31270 Friendship RdBraselton, GA 30517-5608 · Phone (678) 207-4000 · Fax (770) 533-4772

Location 44095 S. Lee StreetBuford, GA 30518-3647 · Phone (770) 932-8519 · Fax (770) 533-4798

Location 5155 Professional DrBaldwin, GA 30511-4000 · Phone (770) 535-3611

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Crumley Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Crumley's NPI number?

The NPI number for Nicole Crumley is 1164122214. It was assigned to this individual provider in the NPPES registry on March 7, 2023. The provider is also known as Nicole Bock.

Where is Nicole Crumley located?

Nicole Crumley practices at 155 Professional Drive, Baldwin, GA 30511. The listed phone number is (706) 776-2368.

What is Nicole Crumley's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Nicole Crumley enrolled in Medicare?

Yes. Nicole Crumley is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicole Crumley was last updated on August 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.