NPIMap

Organization Active NPI

Crestani Family Medicine, PC

  • Family Medicine Physician
  • Huntsville, AL
National Provider Identifier
1033166178
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23539 Issued in AL
Legal business name
CRESTANI FAMILY MEDICINE, PC
Practice address
2745 Bob Wallace Ave SW
Suite D
Huntsville, AL 35805-4158
Phone
(256) 534-1323
Fax
(256) 534-1780
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Panda Jo Palmer
Title
Accounts Manager
Phone
(256) 534-1323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 23539 AL Primary

Addresses

Primary practice location

2745 Bob Wallace Ave SW
Suite D
Huntsville, AL 35805-4158

Mailing address

PO Box 2586
Huntsville, AL 35804-2586
Phone (256) 534-1323

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033166178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2586",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358042586",
            "telephone_number": "256-534-1323",
            "fax_number": "256-534-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 BOB WALLACE AVE SW",
            "address_2": "SUITE D",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358054158",
            "telephone_number": "256-534-1323",
            "fax_number": "256-534-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTANI FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "PANDA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "ACCOUNTS MANAGER",
        "authorized_official_telephone_number": "256-534-1323"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "23539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.