Active NPI
Jason David Crandall
- Licensed Practical Nurse
- Loveland, CO
National Provider Identifier
1184449985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 0335302
- Practice address
- 4575 Byrd Dr
Loveland, CO 80538-7198 - Phone
- (970) 593-3300
- Fax
- (970) 962-4901
- NPI assigned
- Nov 18, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 0335302 | CO | Primary |
Addresses
Primary practice location
4575 Byrd Dr
Loveland, CO 80538-7198
Mailing address
4575 Byrd Dr
Loveland, CO 80538-7198
Phone (970) 593-3300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0335302 | CO | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1184449985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4575 BYRD DR",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805387198",
"telephone_number": "970-593-3300",
"fax_number": "970-962-4901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4575 BYRD DR",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805387198",
"telephone_number": "970-593-3300",
"fax_number": "970-962-4901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANDALL",
"first_name": "JASON",
"middle_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-11-18",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "CO",
"license": "0335302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loveland, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.