Individual provider Active NPI

Tyler Alexis Crisp

  • Pediatric Registered Nurse
  • Liberty Township, OH
National Provider Identifier
1285408047
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
467191 Issued in OH
Practice address
7777 Yankee Rd
Liberty Township, OH 45044-3500
Phone
(513) 803-9600
NPI assigned
Nov 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 467191 OH Primary

Addresses

Primary practice location

7777 Yankee Rd
Liberty Township, OH 45044-3500

Mailing address

463 Columbus Ave Apt 45
Lebanon, OH 45036-2688
Phone (513) 889-7816

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

LicenseStateTypeSpecialty
467191OHMDPediatric Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1285408047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 COLUMBUS AVE APT 45",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450362688",
            "telephone_number": "513-889-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 YANKEE RD",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "450443500",
            "telephone_number": "513-803-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISP",
        "first_name": "TYLER",
        "middle_name": "ALEXIS",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "OH",
            "license": "467191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Township, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.