Individual provider Active NPI

Kristi Eve Crawford

  • Family Nurse Practitioner
  • Santa Rosa Beach, FL
National Provider Identifier
1144934357
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11023914 Issued in FL
Practice address
179 Mack Bayou Loop Ste 201
Santa Rosa Beach, FL 32459-7210
Phone
(850) 233-6922
NPI assigned
Jan 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 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 11023914 FL Primary

Addresses

Primary practice location

179 Mack Bayou Loop Ste 201
Santa Rosa Beach, FL 32459-7210

Mailing address

179 Mack Bayou Loop Ste 201
Santa Rosa Beach, FL 32459-7210
Phone (850) 278-3920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230328003128 FL Practitioner - Nurse Practitioner 7315311602 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11023914FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. Current Accepting new patients
Sacred Heart Health System Inc CurrentSince Mar 15, 2023 Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Mar 15, 2023 Accepting new patients

Locations

36500 Emerald Coast Pkwy
Destin, FL 32541
Phone (850) 269-0301

26 Racetrack Rd NW
Ft Walton Bch, FL 32547
Phone (850) 416-2340

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

120 N Richard Jackson Blvd
Ste 100
Panama City Beach, FL 32407
Phone (850) 233-6922

Interoperability endpoints

  • Direct secure messaging: kristi.ciamillo.1@9582.direct.athenahealth.com

Organizations & group practices 3

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": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1144934357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 MACK BAYOU LOOP STE 201",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324597210",
            "telephone_number": "850-278-3920",
            "fax_number": "850-278-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 MACK BAYOU LOOP STE 201",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324597210",
            "telephone_number": "850-233-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "KRISTI",
        "middle_name": "EVE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11023914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa Beach, FL

Sources for this page

Verify at the official NPI Registry.