Individual provider Active NPI

Autumn Elizabeth Crisp, CNP

  • Women's Health Nurse Practitioner
  • Akron, OH
National Provider Identifier
1205507589
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
95020313 Issued in CA
Practice address
75 Arch St Ste B1
Akron, OH 44304-1474
Phone
(330) 375-4844
Fax
(330) 375-4067
NPI assigned
Sep 25, 2021
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 95020313 CA Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 0029806 OH
Obstetrics Physician 207VX0000X APRN.CNP.0029806 OH

Addresses

Primary practice location

75 Arch St Ste B1
Akron, OH 44304-1474

Mailing address

29054 SW Meek Loop Apt 248
Wilsonville, OR 97070-6512
Phone (216) 466-2424

Other practice location 1

450 Alaskan Way S
Seattle, WA 98104-3387
Phone (916) 798-3615

Other practice location 2

1050 SW 6th Ave
Portland, OR 97204-1156
Phone (916) 798-3615

Other practice location 3

445 S Figueroa St
Los Angeles, CA 90071-1602
Phone (916) 798-3615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA, OH3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20230626002843 OR Practitioner - Nurse Practitioner 7810355641 Reassigns benefits to 1 organization
I20240301001838 WA Practitioner - Nurse Practitioner 7810355641 Reassigns benefits to 1 organization
I20250107000325 OH Practitioner - Nurse Practitioner 7810355641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

161 N Forge St
Akron, OH 44304-1483

51 Park W Blvd
Suite 200
Akron, OH 44320-4215
Phone (330) 869-9777

525 E Market St
Akron, OH 44304-1619

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0029806OHMDObstetrics Physician
95020313CAMDWomen's Health Nurse Practitioner
0029806OHMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Single Specialty CurrentSince May 22, 2023 Accepting new patients
Summa Physicians LLC Single Specialty Current Accepting new patients
Manor Care of Salmon Creek Wa, Association CurrentSince Jan 21, 2024 Accepting new patients
University Hospitals Medical Group Inc Single Specialty CurrentSince May 23, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince May 22, 2023 Accepting new patients
Summa Physicians LLC Single Specialty Past Accepting new patients

Locations

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

11100 Euclid Ave
Cleveland Heights, OH 44106

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

5125 Skyline Rd S
Salem, OR 97306
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1632528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1205507589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29054 SW MEEK LOOP APT 248",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970706512",
            "telephone_number": "216-466-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 ARCH ST STE B1",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041474",
            "telephone_number": "330-375-4844",
            "fax_number": "330-375-4067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Alaskan Way S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981043387",
            "country_code": "US",
            "telephone_number": "916-798-3615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 SW 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972041156",
            "country_code": "US",
            "telephone_number": "916-798-3615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "445 S Figueroa St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900711602",
            "country_code": "US",
            "telephone_number": "916-798-3615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRISP",
        "first_name": "AUTUMN",
        "middle_name": "ELIZABETH",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-25",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "95020313",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "OH",
            "license": "0029806",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "OH",
            "license": "APRN.CNP.0029806",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.