Active NPI
Crystal Ann Casper, RD, LDN
- Registered Dietitian
- Peoria, IL
National Provider Identifier
1003292111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.005880
- Practice address
- 7610 N Orange Prarie Road
Peoria, IL 61615 - Phone
- (309) 589-1001
- NPI assigned
- Jul 31, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.005880 | IL | Primary |
Addresses
Primary practice location
7610 N Orange Prarie Road
Peoria, IL 61615
Mailing address
101 Karen Drive
East Peoria, IL 61611
Phone (309) 712-4962
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.005880 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Networks
- TX HMO D-SNP
- TX HMO
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438300800000",
"number": "1003292111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 KAREN DRIVE",
"city": "EAST PEORIA",
"state": "IL",
"postal_code": "61611",
"telephone_number": "309-712-4962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7610 N ORANGE PRARIE ROAD",
"city": "PEORIA",
"state": "IL",
"postal_code": "61615",
"telephone_number": "309-589-1001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASPER",
"first_name": "CRYSTAL",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-31",
"last_updated": "2015-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.005880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.