Crystal Danner, APRN
Individual provider Active NPI Family Nurse Practitioner · Little Rock, AR
NPI 1104385632 · NPPES record last updated Jul 11, 2024
Key facts
- NPI
- 1104385632
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- A006033 (AR)
- Practice address
- 200 River Market Ave Ste 100
Little Rock, AR 72201-1762 - Phone
- (501) 222-4068
- NPI assigned
- Mar 14, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Venvisor Health of Ar PA
SHC Medical Partners of Arkansas LLC
Practice addresses (Care Compare)
1202 NE McClain Rd
BLDG 7
Bentonville, AR 72712-3875
Phone (203) 901-2493
200 River Market Ave
Suite 100
Little Rock, AR 72201-1762
Phone (501) 267-9870
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 |
|---|---|---|---|---|
| I20240903002906 | AR | Practitioner - Nurse Practitioner | 1850830993 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A006033 | AR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abode Care Partners LTC VB, LLC | Current |
Accepting new patients | |
| Abode Care Partners Al VB, LLC | Current |
Accepting new patients | |
| Icp Arkansas Aco Billing LLC | Current |
Accepting new patients | |
| SHC Medical Partners of Arkansas, LLC | Current |
Accepting new patients | |
| Abode Care Partners Al VB, LLC | Current |
Accepting new patients | |
| Abode Care Partners LTC VB, LLC | Current |
Accepting new patients |
Locations
200 River Market Ave
Ste 500
Little Rock, AR 72201
Phone (501) 492-0099
200 River Market Ave
Ste 100
Little Rock, AR 72201
Phone (501) 267-9870
805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438
805 N Whittington Pkwy
Northfield, KY 40222
Phone (502) 627-7000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A006033 | AR | Yes |
Addresses
Primary practice location
200 River Market Ave Ste 100
Little Rock, AR 72201-1762
Mailing address
200 River Market Ave Ste 100
Little Rock, AR 72201-1762
Phone (501) 222-4068
Other providers in Little Rock, AR
- Kay Baylee Daniels
- Latoshia S Daniels
- Patricee Daniels
- Shatika Daniels
- Raquel D Danko
- Dans-Diabetes and Nutrition Services, LLC
- Dionne Dantzler
- Tykeela N Danzie
- Ahmed Daoud
- Charles W Darby
All providers in Little Rock, AR · Family Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2024. 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.