Individual provider Active NPI

Crystal Monique Fix, ATC/L

  • Athletic Trainer
  • Tempe, AZ
National Provider Identifier
1033482823
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0957 Issued in AZ
Practice address
1492 S Mill Ave
Suite 113
Tempe, AZ 85281-5652
Phone
(480) 257-2726
NPI assigned
Feb 9, 2012
Last updated
Feb 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0957 AZ Primary

Addresses

Primary practice location

1492 S Mill Ave
Suite 113
Tempe, AZ 85281-5652

Mailing address

2629 W Beverly Rd
Phoenix, AZ 85041
Phone (928) 607-4368

Other identifiers 3

IdentifierTypeStateIssuer
0957OtherAZARIZONA BOARD OF ATHLETIC TRAINING
BOC105800OtherBOARD OF CERTIFICATION
1022867OtherNATIONAL ATHLETIC TRAINERS ASSOCIATION

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0957AZMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1033482823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 W BEVERLY RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85041",
            "telephone_number": "928-607-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 S MILL AVE",
            "address_2": "SUITE 113",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852815652",
            "telephone_number": "480-257-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIX",
        "first_name": "CRYSTAL",
        "middle_name": "MONIQUE",
        "credential": "ATC/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "0957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA BOARD OF ATHLETIC TRAINING",
            "identifier": "0957",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF CERTIFICATION",
            "identifier": "BOC105800",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL ATHLETIC TRAINERS ASSOCIATION",
            "identifier": "1022867",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; 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.