Individual provider Active NPI

Crystal M Rivett, CNP

  • Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1134434822
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704221117 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-9505
Fax
(313) 916-9556
NPI assigned
Aug 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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 4704221117 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-9505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20110203000096 MI Practitioner - Nurse Practitioner 3173703550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Oakland College of Medicine and Surgery, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

14500 Hall Rd
Sterling Heights, MI 48313-1229
Phone (586) 247-2700

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

30795 23 Mile Rd
Chesterfield, MI 48047-5720
Phone (586) 421-3150

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704221117MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation CurrentSince Feb 17, 2022 Accepting new patients
Henry Ford Health System CurrentSince Mar 1, 2016 Accepting new patients
Henry Ford Macomb Hospital Corporation Nurse Practitioner CurrentSince Feb 17, 2022 Accepting new patients
Henry Ford Macomb Hospital Corporation Nurse Practitioner Current Accepting new patients
Henry Ford Health System Nurse Practitioner CurrentSince Mar 1, 2016 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

30795 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 421-3000

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

44199 Dequindre Rd
Ste 612
Troy, MI 48085
Phone (248) 964-5170

Interoperability endpoints

  • Direct secure messaging: crivett241657@direct.hfhs.org

Organizations & group practices 6

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 3

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": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1134434822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-9505",
            "fax_number": "313-916-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-9505",
            "fax_number": "313-916-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVETT",
        "first_name": "CRYSTAL",
        "middle_name": "M",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-18",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704221117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.