Individual provider Active NPI

Heather Benson Crowder- Kalla, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbus, GA
National Provider Identifier
1386307833
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN226372 Issued in GA
Practice address
2000 16TH Ave
Columbus, GA 31901-1665
Phone
(706) 320-3770
Fax
(706) 320-3772
NPI assigned
Oct 20, 2021
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN226372 GA Primary

Addresses

Primary practice location

2000 16TH Ave
Columbus, GA 31901-1665

Mailing address

2300 Manchester Expy Ste 2001a
Columbus, GA 31904-6802
Phone (706) 320-3126

Other practice location 1

275 Lee Road 381
Valley, AL 36854-6350
Phone (706) 590-8188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220118000221 GA Practitioner - Nurse Practitioner 6709278146 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Physician Practices LLC CurrentSince Jan 1, 2022 Accepting new patients
St. Francis Physician Practices LLC Current Accepting new patients
Oasis Psychiatric Services, LLC Current Accepting new patients
St. Francis Physician Practices LLC CurrentSince Jan 1, 2022 Accepting new patients
Oasis Psychiatric Services, LLC Current Accepting new patients

Locations

2000 16th Ave
Columbus, GA 31901
Phone (706) 320-3700

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

2300 Manchester Expy
Ste 2001A
Columbus, GA 31904
Phone (706) 320-3126

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.

NPI Registry JSON

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1386307833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY STE 2001A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046802",
            "telephone_number": "706-320-3126",
            "fax_number": "706-320-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 16TH AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011665",
            "telephone_number": "706-320-3770",
            "fax_number": "706-320-3772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Lee Road 381",
            "address_purpose": "LOCATION",
            "city": "Valley",
            "state": "AL",
            "postal_code": "368546350",
            "country_code": "US",
            "telephone_number": "706-590-8188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROWDER- KALLA",
        "first_name": "HEATHER",
        "middle_name": "BENSON",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN226372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.