Active NPI
Landry Crabtree, NP
- Nurse Practitioner
- Edwardsville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209032207
- Practice address
- 2122 Troy Rd
Edwardsville, IL 62025-2540 - Phone
- (618) 433-6410
- NPI assigned
- Mar 25, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 2024047256 | MO | |
| Nurse Practitioner | 363L00000X | 209032207 | IL | Primary |
Addresses
Primary practice location
2122 Troy Rd
Edwardsville, IL 62025-2540
Mailing address
PO Box 959203
Saint Louis, MO 63195-9203
Phone (618) 433-6410
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240
2122 Troy Rd
Suite 130
Edwardsville, IL 62025-2540
Phone (618) 463-7600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024047256 | MO | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Heights Medical Group SC | Current | Accepting new patients | |
| Fairview Heights Medical Group SC | Current | Accepting new patients |
Locations
1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240
4 Memorial Dr
Ste 125
Alton, IL 62002
Phone (618) 433-6410
2122 Troy Rd
Edwardsville, IL 62025
Phone (618) 655-0386
2122 Troy Rd
Ste 130
Edwardsville, IL 62025
Phone (618) 692-9876
660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6433
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba BJC Medical Group of Illinois
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1073022000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758067200000",
"number": "1164224606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 959203",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631959203",
"telephone_number": "618-433-6410",
"fax_number": "618-433-6420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2122 TROY RD",
"city": "EDWARDSVILLE",
"state": "IL",
"postal_code": "620252540",
"telephone_number": "618-433-6410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRABTREE",
"first_name": "LANDRY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-25",
"last_updated": "2025-09-17",
"certification_date": "2025-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "MO",
"license": "2024047256",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209032207",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
"affiliation": "N",
"endpointDescription": "BJC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2122 Troy Rd Ste 130",
"city": "Edwardsville",
"state": "IL",
"country_code": "US",
"postal_code": "620252540",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Edwardsville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.