Active NPI
Connie Jean Crump, PT, DPT
- Physical Therapist
- Marion, IN
National Provider Identifier
1023525979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5002494
- Practice address
- 4201 S Washington St
Marion, IN 46953-4974 - Phone
- (765) 677-1598
- NPI assigned
- Jan 1, 2018
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5002494 | IN | Primary |
Addresses
Primary practice location
4201 S Washington St
Marion, IN 46953-4974
Mailing address
910 Berkley Dr
Marion, IN 46952-2635
Phone (765) 603-6381
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5002494 | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514764800000",
"number": "1023525979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 BERKLEY DR",
"city": "MARION",
"state": "IN",
"postal_code": "469522635",
"telephone_number": "765-603-6381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 S WASHINGTON ST",
"city": "MARION",
"state": "IN",
"postal_code": "469534974",
"telephone_number": "765-677-1598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUMP",
"first_name": "CONNIE",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-01",
"last_updated": "2018-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "5002494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.