Individual provider Active NPI

Kentston Cripe, DPM

  • Podiatrist
  • Chico, CA
National Provider Identifier
1073076782
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5846 Issued in CA
Practice address
2103 Forest Ave
Chico, CA 95928-7680
Phone
(530) 895-3668
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5846 CA Primary

Addresses

Primary practice location

2103 Forest Ave
Chico, CA 95928-7680

Mailing address

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Other practice location 1

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

Other practice location 2

1401 21st St Ste R
Sacramento, CA 95811-5226
Phone (916) 300-9633

Other identifiers 1

IdentifierTypeStateIssuer
100255147MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220513001372 CA Practitioner - Podiatry 7911384961 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

906 Cirby Way
Suite 100
Roseville, CA 95661-4475
Phone (916) 243-5033

Hospital & facility affiliations

  • Sutter Care at Home Home health agency, Roseville, CA, CCN 057545
  • Sutter Auburn Faith Vna & Hospice Home health agency, Auburn, CA, CCN 557292
  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue57
Removal of skin lesions1-10
Removal of nail tissue24
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5846CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chico Podiatry Group Podiatrist CurrentSince May 9, 2022 Accepting new patients
Roseville Foot and Ankle PC Podiatrist CurrentSince Sep 27, 2022 Accepting new patients
Michael N Brown, DPM, Inc PastSince May 9, 2022 Accepting new patients

Locations

2103 Forest Ave
Chico, CA 95928
Phone (530) 895-3668

906 Cirby Way
Ste 100
Roseville, CA 95661
Phone (916) 243-5033

1401 21st St
Ste R
Sacramento, CA 95811
Phone (316) 516-2853

Interoperability endpoints

  • Direct secure messaging: kcripe653393@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1073076782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 FOREST AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959287680",
            "telephone_number": "530-895-3668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 E Roosevelt St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850084973",
            "country_code": "US",
            "telephone_number": "602-344-5011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 21st St Ste R",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958115226",
            "country_code": "US",
            "telephone_number": "916-300-9633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRIPE",
        "first_name": "KENTSTON",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "5846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100255147",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.