Individual provider Active NPI

Craig Crossman, PTA

  • Physical Therapy Assistant
  • Georgetown, TX
National Provider Identifier
1356739080
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2050823 Issued in TX
Practice address
705 E 13TH St
Georgetown, TX 78626
Phone
(512) 743-1781
NPI assigned
Jan 5, 2015
Last updated
Aug 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2050823 TX Primary
Skilled Nursing Facility 314000000X A03000 KY

Addresses

Primary practice location

705 E 13TH St
Georgetown, TX 78626

Mailing address

202 Pennsylvania Ave
Louisville, KY 40206-1540

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
2050823TXMDPhysical Therapy Assistant
A03000KYMDSkilled Nursing Facility

NPI Registry JSON

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1356739080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 PENNSYLVANIA AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402061540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 E 13TH ST",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "78626",
            "telephone_number": "512-743-1781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSMAN",
        "first_name": "CRAIG",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-05",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2050823",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KY",
            "license": "A03000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.