Individual provider Active NPI

Anna M Reyes-Crawhorn

  • Psychiatric/Mental Health Nurse Practitioner
  • Jeffersonville, IN
National Provider Identifier
1154978732
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71008870A Issued in IN
Practice address
1507 Spring Street
Jeffersonville, IN 47130-2939
Phone
(812) 901-6881
Fax
(812) 285-8392
NPI assigned
Aug 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71008870A IN Primary

Addresses

Primary practice location

1507 Spring Street
Jeffersonville, IN 47130-2939

Mailing address

1507 Spring Street
Jeffersonville, IN 47130-2939
Phone (407) 347-4536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190829000408 IN Practitioner - Nurse Practitioner 5092043067 Reassigns benefits to 1 organization
I20200506003108 KY Practitioner - Nurse Practitioner 5092043067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lake Substance Abuse Solutions LLCGroup PAC ID 8123440401, 20 clinicians

Practice addresses (Care Compare)

1143 Fairway St
Suite 103
Bowling Green, KY 42103-2452
Phone (833) 525-3727

1507 Spring St
Jeffersonville, IN 47130-2939
Phone (833) 525-3727

Hospital & facility affiliations

  • Baptist Health Floyd Hospital, New Albany, IN, CCN 150044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71008870AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Substance Abuse Solutions LLC Psychiatric/Mental Health CurrentSince Apr 1, 2020 Accepting new patients
Major Hospital Past Accepting new patients

Locations

225 W Canton Ave
Winter Park, FL 32789

225 W Canton Ave
Ste 600
Winter Park, FL 32789
Phone (407) 347-4536

510 Spring St
Jeffersonvlle, IN 47130
Phone (812) 282-1888

1507 Spring St
Jeffersonvlle, IN 47130
Phone (812) 280-0413

1830 Destiny Ln
Ste 110
Bowling Green, KY 42104
Phone (270) 846-3338

1143 Fairway St
Ste 103
Bowling Green, KY 42103
Phone (812) 901-6881

Organizations & group practices 2

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 1

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": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1154978732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 SPRING STREET",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471302939",
            "telephone_number": "407-347-4536",
            "fax_number": "812-285-8392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 SPRING STREET",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471302939",
            "telephone_number": "812-901-6881",
            "fax_number": "812-285-8392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES-CRAWHORN",
        "first_name": "ANNA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71008870A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.