Individual provider Active NPI

Heidi Croston

  • Family Nurse Practitioner
  • Massillon, OH
National Provider Identifier
1124554258
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0026846 Issued in OH
Practice address
6395 Great Court Cir NW
Massillon, OH 44646-9539
Phone
(330) 418-7614
NPI assigned
May 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.306332 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.0026846 OH Primary

Addresses

Primary practice location

6395 Great Court Cir NW
Massillon, OH 44646-9539

Mailing address

6395 Great Court Cir NW
Massillon, OH 44646-9539
Phone (330) 418-7614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20220413002293 OH Practitioner - Certified Clinical Nurse Specialist (CNS) 2860888120 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.306332OHMDRegistered Nurse
APRN.CNP.0026846OHMDFamily Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1124554258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6395 GREAT COURT CIR NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469539",
            "telephone_number": "330-418-7614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6395 GREAT COURT CIR NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469539",
            "telephone_number": "330-418-7614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSTON",
        "first_name": "HEIDI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-10",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.306332",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0026846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

Verify at the official NPI Registry.