Phyllis Rene Crafton

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SL004844L Issued in PA

Legal business name

PHYLLIS RENE CRAFTON

Practice address

104 Applewood LN
Slippery Rock, PA 16057-2903

Phone

(724) 321-4259

NPI assigned

Sep 2, 2014

Organization subpart

No

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

Authorized official

Name

Phyllis Rene Crafton, MSCCCSLP

Title

Speech Therapist

Phone

(724) 321-4259

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409616000000",
    "number": "1124428776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 APPLEWOOD LN",
            "city": "SLIPPERY ROCK",
            "state": "PA",
            "postal_code": "160572903",
            "telephone_number": "724-321-4259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 APPLEWOOD LN",
            "city": "SLIPPERY ROCK",
            "state": "PA",
            "postal_code": "160572903",
            "telephone_number": "724-321-4259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYLLIS RENE CRAFTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-02",
        "last_updated": "2014-09-02",
        "status": "A",
        "authorized_official_last_name": "CRAFTON",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "RENE",
        "authorized_official_title_or_position": "SPEECH THERAPIST",
        "authorized_official_telephone_number": "724-321-4259",
        "authorized_official_credential": "MSCCCSLP"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "SL004844L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Slippery Rock, PA
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.