Individual provider Active NPI

Brynn F Crisp, NP

  • Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1265056014
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
29660 Issued in TN
Practice address
301 Med Tech Pkwy Ste 120
Johnson City, TN 37604-2631
Phone
(423) 794-5590
Fax
(423) 794-5877
NPI assigned
Jun 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 29660 TN Primary

Addresses

Primary practice location

301 Med Tech Pkwy Ste 120
Johnson City, TN 37604-2631

Mailing address

PO Box 3889
Johnson City, TN 37602-3889
Phone (423) 794-2457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29660TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Franklin Healthcare Associates PLLC CurrentSince Apr 23, 2023 Accepting new patients

Organizations & group practices 1

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": "1591488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1265056014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3889",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376023889",
            "telephone_number": "423-794-2457",
            "fax_number": "423-283-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MED TECH PKWY STE 120",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042631",
            "telephone_number": "423-794-5590",
            "fax_number": "423-794-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISP",
        "first_name": "BRYNN",
        "middle_name": "F",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-07",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "29660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.