Katie Rae Crawford, PA-C
Individual provider Active NPI Medical Physician Assistant · Dardanelle, AR
NPI 1073159133 · NPPES record last updated Feb 3, 2020
Key facts
- NPI
- 1073159133
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PT2019-051 (AR)
- Practice address
- 1176 State Highway 22 W Ste B
Dardanelle, AR 72834-3006 - Phone
- (479) 229-3004
- Fax
- (870) 994-7488
- NPI assigned
- Nov 25, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 16
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bradley Bibb MD PLLC
Access Medical Clinic Arkansas LLC
Practice addresses (Care Compare)
1176 State Hwy 22 W B
AMC Dardanelle
Dardanelle, AR 72834-3006
Phone (479) 229-3004
122 Southern Dr
Ashdown, AR 71822-8668
Phone (870) 600-4050
Hospital & facility affiliations
- St Marys Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191212000499 | AR | Practitioner - Physician Assistant | 1658704200 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bradley Bibb, MD PLLC | Current |
Accepting new patients | |
| Access Medical Clinic Arkansas LLC | Current |
Accepting new patients | |
| Bradley Bibb MD PLLC | Current |
Accepting new patients | |
| Access Medical Clinic Arkansas LLC | Current |
Accepting new patients | |
| Bradley Bibb MD PLLC | Past | Accepting new patients | |
| Bradley Bibb MD PLLC | Past | Accepting new patients | |
| Bradley Bibb MD PLLC | Past | Accepting new patients |
Locations
49 Highway 62 412
Ste 412
Ash Flat, AR 72513
1176 State Highway 22 W
Ste B
Dardanelle, AR 72834
Phone (479) 229-3004
16723 Highway 62
Garfield, AR 72732
Phone (870) 219-7706
101 W Main St
Hardy, AR 72542
Phone (870) 856-2100
106 Highway 62 W
Salem, AR 72576
Phone (870) 895-2762
3809 E 9th St
Ste 15
Texarkana, AR 71854
Phone (870) 621-0080
Interoperability endpoints
- katie.crawford.1@15024.direct.athenahealth.com
- katie.crawford.1@2424.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PT2019-051 | AR | Yes |
Addresses
Primary practice location
1176 State Highway 22 W Ste B
Dardanelle, AR 72834-3006
Mailing address
101 W Main St
Hardy, AR 72542-9566
Other providers in Dardanelle, AR
- Randilyn Brunson
- Stephannie Cawiezell
- Anastasia Desiree Christensen
- Heather Coffman
- Angie Nichole Crane
- Tammy Creekmore
- Katie E Crow-Goates
- Joshua Craig Cummins
- Stevie Cursh
- Tina Curtis
All providers in Dardanelle, AR · Medical Physician Assistant in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.