Individual provider Active NPI

Amber Michelle Crouch, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1053179937
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.0999726-NP Issued in CO
Practice address
2121 Academy Cir Ste 203
Colorado Springs, CO 80909-1600
Phone
(850) 699-4190
NPI assigned
Mar 6, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0999726-NP CO Primary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X RN.1621768 CO

Addresses

Primary practice location

2121 Academy Cir Ste 203
Colorado Springs, CO 80909-1600

Mailing address

2121 Academy Cir Ste 203
Colorado Springs, CO 80909-1600
Phone (719) 205-0184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240805000506 CO Practitioner - Nurse Practitioner 0547707804 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.1621768COMDRegistered Nurse
APN.0999726-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elemental Psychiatric Care, LLC Single Specialty CurrentSince Jun 1, 2024 Accepting new patients

Locations

2121 Academy Cir
Ste 203
Colorado Springs, CO 80909
Phone (719) 205-0184

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1053179937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 ACADEMY CIR STE 203",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091600",
            "telephone_number": "719-205-0184",
            "fax_number": "888-334-6487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 ACADEMY CIR STE 203",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809091600",
            "telephone_number": "850-699-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "AMBER",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0999726-NP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.1621768",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.