NPIMap

Individual provider Active NPI

Heidi K Crull, ANP-BC

  • Adult Health Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1013281427
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2011040496 Issued in MO
Practice address
2115 S Fremont Ave
Ste 3300
Springfield, MO 65804-2239
Phone
(417) 820-5200
Fax
(417) 820-5220
NPI assigned
Mar 2, 2012
Last updated
Jul 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2011040496 MO Primary

Addresses

Primary practice location

2115 S Fremont Ave
Ste 3300
Springfield, MO 65804-2239

Mailing address

PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620

Other identifiers 4

IdentifierTypeStateIssuer
10132814257MedicaidMO
191534758MedicaidAR
P01036357OtherMORR MCR
431560263OtherMOTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140829000102 CO Practitioner - Nurse Practitioner 0244490258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rocky Mountain Gastroenterology Associates, PLLCGroup PAC ID 5991797532, 37 clinicians

Practice addresses (Care Compare)

10001 Washington St
Thornton, CO 80229-2050
Phone (303) 252-4442

13111 E Briarwood Ave
Suite 300
Centennial, CO 80112-3913
Phone (303) 671-5553

14000 E Arapahoe Rd
Suite 300
Centennial, CO 80112-4045
Phone (303) 671-5553

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2011040496MOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Gastroenterology Associates, PLLC CurrentSince Sep 8, 2014 Accepting new patients

Locations

1444 S Potomac St
Ste 100
Aurora, CO 80012
Phone (303) 337-2794

13111 E Briarwood Ave
Ste 300
Centennial, CO 80112
Phone (303) 671-5533

14000 E Arapahoe Rd
Ste 300
Centennial, CO 80112
Phone (303) 617-7782

3333 S Wadsworth Blvd
Unit D100
Lakewood, CO 80227

10001 Washington St
Thornton, CO 80229
Phone (303) 252-0083

Networks

  • CO HMO
  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO D-SNP
  • NM HMO C-SNP

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1013281427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 S FREMONT AVE",
            "address_2": "STE 3300",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042239",
            "telephone_number": "417-820-5200",
            "fax_number": "417-820-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRULL",
        "first_name": "HEIDI",
        "middle_name": "K",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2011040496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10132814257",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191534758",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P01036357",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.