Individual provider Active NPI

Tamra Lynn Crouch, FNP

  • Family Nurse Practitioner
  • Festus, MO
National Provider Identifier
1104301100
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018017919 Issued in MO
Practice address
1400 US Highway 61
Festus, MO 63028-4100
Phone
(636) 933-5337
NPI assigned
Sep 26, 2018
Sex
Female
Sole proprietor
No

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2018017919 MO Primary

Addresses

Primary practice location

1400 US Highway 61
Festus, MO 63028-4100

Mailing address

412 Park St
Farmington, MO 63640-2656
Phone (573) 330-7588

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Tamra.Crouch@doc.mo.gov Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230313000644 MO Practitioner - Nurse Practitioner 4082088190 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Adult Hospitalists Jefferson LLCGroup PAC ID 8628205598, 58 clinicians

Practice addresses (Care Compare)

1400 US Hwy 61
Festus, MO 63028-4100
Phone (636) 933-8091

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Washington County Memorial Hospital CurrentSince Feb 1, 2023 Accepting new patients
Iron County Hospital District Current Accepting new patients
Washington County Memorial Hospital CurrentSince Feb 1, 2023 Accepting new patients
Mercy Clinic Adult Hospitalists- Jefferson, LLC CurrentSince Sep 30, 2024 Accepting new patients

Locations

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

300 Health Way Dr
Potosi, MO 63664
Phone (573) 438-2977

Interoperability endpoints

  • Direct secure messaging: tamra.crouch@doc.mo.gov

Organizations & group practices 4

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 1

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": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1104301100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 PARK ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636402656",
            "telephone_number": "573-330-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 US HIGHWAY 61",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284100",
            "telephone_number": "636-933-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "TAMRA",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018017919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Tamra.Crouch@doc.mo.gov",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13698 Airport Rd",
            "city": "Bowling Green",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633342733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.