Individual provider Active NPI

Brandon Vincent Crispi, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Clinton, MO
National Provider Identifier
1295614600
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2025029414 Issued in MO
Practice address
1600 N 2ND St
Clinton, MO 64735-1192
Phone
(660) 885-5511
Fax
(660) 885-2619
NPI assigned
Aug 29, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2025029414 MO Primary

Addresses

Primary practice location

1600 N 2ND St
Clinton, MO 64735-1192

Mailing address

1600 N 2ND St
Clinton, MO 64735-1192
Phone (660) 890-7182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251028003810 MO Practitioner - Nurse Practitioner 9931698115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden Valley Memorial Hospital DistrictGroup PAC ID 4688561814, 138 clinicians

Practice addresses (Care Compare)

1600 N 2ND St
Clinton, MO 64735-1192
Phone (660) 885-5511

1602 N 2ND St
Clinton, MO 64735-1192

603 E Gaines Dr
GVMH Medical East
Clinton, MO 64735-3205
Phone (660) 885-8171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025029414MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Valley Memorial Hospital District CurrentSince Nov 1, 2025 Accepting new patients
Golden Valley Memorial Hospital District CurrentSince Nov 1, 2025 Accepting new patients

Locations

1602 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

1600 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1295614600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N 2ND ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647351192",
            "telephone_number": "660-890-7182",
            "fax_number": "660-885-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N 2ND ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647351192",
            "telephone_number": "660-885-5511",
            "fax_number": "660-885-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISPI",
        "first_name": "BRANDON",
        "middle_name": "VINCENT",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2025029414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MO

Sources for this page

Verify at the official NPI Registry.