Individual provider Active NPI

Christal Vanessa Crooks, M.D.

  • Family Medicine Physician
  • Eugene, OR
National Provider Identifier
1366975559
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD197707 Issued in OR
Practice address
4135 Quest Dr
Eugene, OR 97402-8768
Phone
(541) 461-8006
Fax
(541) 463-2198
NPI assigned
Apr 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD197707 OR Primary

Addresses

Primary practice location

4135 Quest Dr
Eugene, OR 97402-8768

Mailing address

PO Box 1648
Eugene, OR 97440-1648
Phone (541) 687-4900

Other practice location 1

208 Medical Park Blvd
Bristol, TN 37620-7343
Phone (423) 990-3012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200610000943 OR Practitioner - Family Practice 9638590045 Reassigns benefits to 2 organizations
I20241008001729 WA Practitioner - Family Practice 9638590045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Univ of Central Florida, College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

3550 N Interstate Ave
Portland, OR 97227-1196
Phone (800) 813-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Sep 23, 2024 Accepting new patients
Oregon Healthcare Resources, LLC CurrentSince Jul 27, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Sep 23, 2024 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

4135 Quest Dr
Eugene, OR 97402
Phone (541) 461-8006

3550 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321

500 NE Multnomah St
Fl 11
Portland, OR 97232

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

2000 N 19th St
Springfield, OR 97477
Phone (541) 284-1694

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: ccrooks@yourcarecommunity.org

Organizations & group practices 3

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1366975559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1648",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974401648",
            "telephone_number": "541-687-4900",
            "fax_number": "541-463-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 QUEST DR",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974028768",
            "telephone_number": "541-461-8006",
            "fax_number": "541-463-2198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207343",
            "country_code": "US",
            "telephone_number": "423-990-3012",
            "fax_number": "423-990-3045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROOKS",
        "first_name": "CHRISTAL",
        "middle_name": "VANESSA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD197707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.