MEDICARE: JONATHAN CROOM PARAMEDIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146L00000X	Paramedic	P081109	NC

General Provider Information

NPI Number	:	1386599595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN CROOM PARAMEDIC

Provider Business Mailing Address
First Line	:	1717 W 5TH ST
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-1603
Country	:	US
Telephone Number	:	252-905-3961
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 W 5TH ST
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-1603
Country	:	US
Telephone Number	:	252-905-3961
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ JONATHAN CROOM PARAMEDIC” Practice Location

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