Individual provider Active NPI

Crystal Weaver

  • Case Manager/Care Coordinator
  • Dayton, OH
National Provider Identifier
1407582745
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
119 Indianola Ave
Dayton, OH 45405-3538
Phone
(937) 718-1610
NPI assigned
Jul 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

119 Indianola Ave
Dayton, OH 45405-3538

Mailing address

119 Indianola Ave
Dayton, OH 45405-3538
Phone (937) 718-1610

Other practice location 1

500 Madison Ave Ste 200
Toledo, OH 43604-1230
Phone (567) 312-8700

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mentoring 1 on 1 Case Manager/Care Coordinator CurrentSince Nov 12, 2023 Accepting new patients
Ohio Seeds of Hope Case Manager/Care Coordinator CurrentSince Aug 3, 2025 Accepting new patients

Organizations & group practices 2

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": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1407582745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 INDIANOLA AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454053538",
            "telephone_number": "937-718-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 INDIANOLA AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454053538",
            "telephone_number": "937-718-1610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Madison Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436041230",
            "country_code": "US",
            "telephone_number": "567-312-8700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "CRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-28",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.