Jacky Crissman

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TE1002721 Issued in PA

Practice address

142 Clearview Cir
Butler, PA 16001-1565

Phone

(724) 285-5351

NPI assigned

Aug 29, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jacky.l.crissman@upmcdirect.com

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1376943142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 CLEARVIEW CIR",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160011565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 CLEARVIEW CIR",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160011565",
            "telephone_number": "724-285-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISSMAN",
        "first_name": "JACKY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-29",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE1002721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacky.l.crissman@upmcdirect.com",
            "affiliation": "N",
            "endpointDescription": "secure UPMC direct address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "142 Clearview Cir",
            "city": "Butler",
            "state": "PA",
            "country_code": "US",
            "postal_code": "160011565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rebecca Leigh Cramer, DPT
• Michaele A Crawford, D.P.M.
• Kristen Cress, MSN, FNP-BC
• William J Cress, LSW
• Rosanne Crider
• Natalie Marie Crissman, MA, NCC, LPC
• Emily Cuba, PA-C
• James Kent Culley, P.T.
• Nancy Culley
• Molly Harlacker Cupler, MSOT, OTR/L

• Physical Therapy Assistant in Butler, PA
• Providers in Butler, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.