Individual provider Active NPI

Kolean Crawford, NURSE PRACTITIONER

  • Nurse Practitioner
  • Granbury, TX
National Provider Identifier
1073284642
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1055114 Issued in TX
Practice address
1308 Paluxy Rd Ste 303
Granbury, TX 76048-5609
Phone
(817) 579-3948
NPI assigned
Sep 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1055114 TX Primary

Addresses

Primary practice location

1308 Paluxy Rd Ste 303
Granbury, TX 76048-5609

Mailing address

1628 County Road 2003
Glen Rose, TX 76043-5905
Phone (254) 396-5122

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kolean.crawford.1@1293.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20211021003240 TX Practitioner - Nurse Practitioner 3476941584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hood Medical GroupGroup PAC ID 2567446669, 56 clinicians

Practice addresses (Care Compare)

1009 NE Big Bend Trail
Lake Granbury Primare Care
Glen Rose, TX 76043-4450
Phone (254) 897-3310

1308 E Paluxy Rd
Granbury, TX 76048-5655

1310 B Paluxy Rd
Granbury, TX 76048-5655

1310 Paluxy Rd
Granbury, TX 76048-5655
Phone (817) 579-2963

1318 Paluxy Rd
Granbury, TX 76048-5655
Phone (817) 573-8805

507 SW Big Bend TRL
Unit J
Glen Rose, TX 76043-4450
Phone (254) 897-3444

Hospital & facility affiliations

  • Glen Rose Medical Center Hospital, Glen Rose, TX, CCN 450451
  • Lake Granbury Medical Center Hospital, Granbury, TX, CCN 450596

Merit-based Incentive Payment System (MIPS)

Final score
89.53 of 100Reported as apm
Quality
79.07
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1055114TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hood Medical Group CurrentSince Oct 18, 2021 Accepting new patients
Hood Medical Group Nurse Practitioner CurrentSince Oct 18, 2021 Accepting new patients

Locations

507 SW Big Bend Trl
Glen Rose, TX 76043
Phone (254) 897-3444

1308 Paluxy Rd
Ste 303
Granbury, TX 76048
Phone (817) 579-3906

1308 Paluxy Rd
Ste 301
Granbury, TX 76048
Phone (817) 573-3272

1310 Paluxy Rd
Granbury, TX 76048
Phone (817) 573-2273

3801 E US Highway 377
Ste 100
Granbury, TX 76049
Phone (817) 573-1380

Organizations & group practices 2

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 2

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": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1073284642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 COUNTY ROAD 2003",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760435905",
            "telephone_number": "254-396-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 PALUXY RD STE 303",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485609",
            "telephone_number": "817-579-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "KOLEAN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1055114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kolean.crawford.1@1293.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1308 Paluxy Rd Ste 303",
            "city": "Granbury",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760485609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.