Active NPI
William Ward Crissman, PA
- Physician Assistant
- Tallahassee, FL
National Provider Identifier
1316278674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9105322
- Practice address
- 2626 Capital Medical Blvd
Tallahassee, FL 32308-4402 - Phone
- (850) 325-4242
- Fax
- (904) 332-4339
- NPI assigned
- Jan 26, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9105322 | FL | Primary |
Addresses
Primary practice location
2626 Capital Medical Blvd
Tallahassee, FL 32308-4402
Mailing address
4311 Salisbury Rd
Jacksonville, FL 32216-6123
Phone (904) 332-4300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kite Emergency Physicians LLC | Past | Accepting new patients | |
| Kingsley Avenue Emergency Physicians LLC | Past | Accepting new patients | |
| Florida Em-I Medical Services, PA | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 5
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.
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- NPI 1609296011
Physician Assistant
-
- Emergency Medicine Physician
- Orange Park, FL
- NPI 1679915300
-
- Emergency Medicine Physician
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264464000000",
"number": "1316278674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4311 SALISBURY RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322166123",
"telephone_number": "904-332-4300",
"fax_number": "907-332-4339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2626 CAPITAL MEDICAL BLVD",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084402",
"telephone_number": "850-325-4242",
"fax_number": "904-332-4339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRISSMAN",
"first_name": "WILLIAM",
"middle_name": "WARD",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-26",
"last_updated": "2010-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9105322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.