Individual provider Active NPI

Crystal Kay Lindahl, NP

  • Women's Health Nurse Practitioner
  • Grants Pass, OR
National Provider Identifier
1366607483
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
202210649NP-PP Issued in OR
Practice address
1075 SW Grandview Ave Ste 200
Grants Pass, OR 97527-5118
Phone
(701) 240-1661
NPI assigned
Jul 29, 2008
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 342516 OH
Women's Health Nurse Practitioner 363LW0102X 202210649NP-PP OR Primary

Addresses

Primary practice location

1075 SW Grandview Ave Ste 200
Grants Pass, OR 97527-5118

Mailing address

1075 SW Grandview Ave Ste 200
Grants Pass, OR 97527-5118
Phone (701) 240-1661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20220812002535 OR Practitioner - Nurse Practitioner 8628451341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Women's Health Center of Southern Oregon PCGroup PAC ID 8628041720, 15 clinicians

Practice addresses (Care Compare)

1075 SW Grandview Ave
Suite 200
Grants Pass, OR 97527-5118
Phone (541) 479-8363

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
342516OHMDHome Health Registered Nurse
202210649NP-PPORMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Health Center of Southern Oregon PC CurrentSince Sep 12, 2022 Accepting new patients

Locations

1075 SW Grandview Ave
Grants Pass, OR 97527
Phone (541) 479-8363

1075 SW Grandview Ave
Ste 200
Grants Pass, OR 97527
Phone (541) 479-8363

Interoperability endpoints

  • Direct secure messaging: crystallindahl@whcso.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1366607483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 SW GRANDVIEW AVE STE 200",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275118",
            "telephone_number": "701-240-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 SW GRANDVIEW AVE STE 200",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275118",
            "telephone_number": "701-240-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDAHL",
        "first_name": "CRYSTAL",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "OH",
            "license": "342516",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": "202210649NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.