Kristy L Cromblin, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

2022035595 Issued in MO

Practice address

625 19TH Street South
Birmingham, AL 35233-1900

Phone

(205) 934-4793

NPI assigned

Oct 31, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1023725975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631011400",
            "telephone_number": "314-436-9300",
            "fax_number": "314-925-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 19TH STREET SOUTH",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900",
            "telephone_number": "205-934-4793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 Olive St",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631011400",
            "country_code": "US",
            "telephone_number": "314-436-9300",
            "fax_number": "314-925-1305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROMBLIN",
        "first_name": "KRISTY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2022035595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristy@dhwstl.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "916 Olive St",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631011400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jordan Harper Crocker, M.D.
• Mary Alice Crocker, MD
• Maureen Crocker, P.T.
• Rodney Christian Crocker, PTA
• Kaylee B Crockett, PHD
• Mark Cromer
• Randall Q Cron, M.D.
• Mary A Cronin, CRNP
• Jennifer Irene Crook, DNP, MPH, PMHNP-BC
• Tatyana Mone'T Crook, M.ED, ALC

• General Practice Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• General Practice Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.