KAITLYN JANE CROOKER DO
NPI 1245083468
Student in an Organized Health Care Education/Training Program in Detroit, MI

Q: What is Kaitlyn Crooker's NPI number?

The NPI number for Kaitlyn Crooker is 1245083468. It was assigned to this individual provider in the NPPES registry on April 8, 2024.

Q: What is Kaitlyn Crooker's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Kaitlyn Crooker was last updated on April 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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 April 08, 2024PECOS Enrolled

2799 W GRAND BLVD # 258, DETROIT, MI 48202(313) 916-1553 Get Directions Write a Review

NPPES record last updated: April 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Kaitlyn Jane Crooker Do NPPES

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

KAITLYN JANE CROOKER DO (NPI 1245083468) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245083468

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameKAITLYN JANE CROOKERCredential: DO

Location Address2799 W GRAND BLVD # 258Detroit, MI 48202-2689

Mailing Address3310 Liberty AveAlameda, CA 94501-3107 · (510) 637-9089

Phone(313) 916-1553

Sole ProprietorYes

Enumeration DateApril 8, 2024

NPPES CertifiedApril 8, 2024

✔ NPI 1245083468 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2799 W GRAND BLVD # 258, Detroit, MI 48202

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kaitlyn Jane Crooker Do 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.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CONNOR MATTHEW BUNCH MD

Student in an Organized Health Care Education/Training Program