Gene Allen Crist, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-071169 Issued in IL

Practice address

10988 Bartel Blvd
Galena, IL 61036-8222

Phone

(815) 777-0900

Fax

(815) 777-0903

NPI assigned

May 11, 2006

Last updated

Jun 26, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• G Allen Crist Professional name

Medicare fee-for-service enrollment

Enrolled in IL, IA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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

• Medical Associates Clinic P C

  • Multi-Specialty Clinic/Center
  • Dubuque, IA
  • NPI 1457300790

  IL

  Medicare reassignment NPD
• Lloyd Callaway, Jr., M.D., S.C.

  • Specialist
  • Galena, IL
  • NPI 1649244427
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1003866104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4100",
            "fax_number": "563-584-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10988 BARTEL BLVD",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610368222",
            "telephone_number": "815-777-0900",
            "fax_number": "815-777-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIST",
        "first_name": "GENE",
        "middle_name": "ALLEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-071169",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "03204",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036071169",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "G ALLEN",
            "last_name": "CRIST",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Consedine Pharmacy Inc (Clingman Pharmacy)
• County of Jo Daviess (Jo Daviess County Transit)
• County of Jo Daviess
• County of Jo Daviess
• Bonnie Cox
• Alexandra T Dalton
• Gregory Dammann, M.D.
• Thomas John Dennis, LCPC
• Margaret E Dittmar, MS, FNP-BC
• Karen Durrant, PHARMD, RPH

• Family Medicine Physician in Galena, IL
• Providers in Galena, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; 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.