Crystal Marie Travis

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN.CNP.14867 Issued in OH

Practice address

901 Washington St
Portsmouth, OH 45662-3944

Phone

(740) 354-1010

NPI assigned

Jun 20, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Miss Crystal Marie Jordan Former name

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BIDBDA/Endpoint/BIDBDA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Action Committee of Pike County

  • Primary Care Clinic/Center
  • Portsmouth, OH
  • NPI 1578974929
  Medicare reassignment NPD
• Shawnee Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portsmouth, OH
  • NPI 1336173236
  Medicare reassignment NPD
• Community Action Committee of Pike County

  • Primary Care Clinic/Center
  • Jackson, OH
  • NPI 1114194347
  NPD
• Community Action Committee of Pike County

  • Federally Qualified Health Center (FQHC)
  • Piketon, OH
  • NPI 1205644614
  NPD
• Community Action Committee of Pike County

  • Primary Care Clinic/Center
  • Waverly, OH
  • NPI 1760659171
  NPD
• Community Action Committee of Pike County

  • Primary Care Clinic/Center
  • Piketon, OH
  • NPI 1811164254
  NPD
• Shawnee Mental Health Center, Inc.

  • Community/Retail Pharmacy
  • Portsmouth, OH
  • NPI 1992524045
  NPD
• Community Action Committee of Pike County

  • Federally Qualified Health Center (FQHC)
  • Jackson, OH
  • NPI 1023100955
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1003255266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WASHINGTON ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623944",
            "telephone_number": "740-354-7702",
            "fax_number": "740-353-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WASHINGTON ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623944",
            "telephone_number": "740-354-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14590 State Route 93",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "OH",
            "postal_code": "456408977",
            "country_code": "US",
            "telephone_number": "740-286-2826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.14867-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.14867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "JORDAN",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kerstin Toomey
• Nathan Tope, CDCA
• Nicholas Scott Toppins, APRN
• Ibrahim S Tora, MD
• Township of Clay Trustees
• Kane Traylor, CDCA
• Arjayra Lynne Treadway, CNP
• Codie Allen Trent, CMS
• Trinidad Orthopaedics and Sportsmedicine Inc
• Gerardo Dumlao Trinidad, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.