Individual provider Active NPI

Crystal R. Barrows, RD

  • Renal Nutrition Registered Dietitian
  • Chandler, AZ
National Provider Identifier
1447466610
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Nutrition Registered DietitianTaxonomy code 133VN1005X
License
970809 Issued in AZ
Practice address
3100 W Ray Rd Ste 201
Chandler, AZ 85226-2472
Phone
(623) 399-6825
Fax
(623) 505-3474
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered Dietitian 133VN1005X 970809 AZ Primary

Addresses

Primary practice location

3100 W Ray Rd Ste 201
Chandler, AZ 85226-2472

Mailing address

18001 N 79TH Ave Ste A12
Glendale, AZ 85308-8398
Phone (623) 399-6825

Other identifiers 2

IdentifierTypeStateIssuer
AZ LICENSEOtherAZ970809
212447MedicaidAZ

Other names 1

  • Miss Crystal R Barraza Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070621000621 AZ Practitioner - Registered Dietitian Or Nutrition Professional 6800995473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Am Nutrition ServicesGroup PAC ID 1254430580, 48 clinicians

Practice addresses (Care Compare)

1910 S Stapley Dr
Suite 221
Mesa, AZ 85204-6680
Phone (623) 399-6825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
970809AZMDRenal Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Am Nutrition Services Dietitian, Registered CurrentSince Nov 9, 2020 Accepting new patients
Akdhc, LLC Past Accepting new patients
Akdhc, LLC Past Accepting new patients

Locations

3100 W Ray Rd
Ste 200
Chandler, AZ 85226

3100 W Ray Rd
Ste 201
Chandler, AZ 85226
Phone (269) 312-1446

18001 N 79th Ave
Ste A12
Glendale, AZ 85308
Phone (623) 321-5380

1910 S Stapley Dr
Ste 221
Mesa, AZ 85204
Phone (480) 573-2262

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1447466610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18001 N 79TH AVE STE A12",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088398",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 W RAY RD STE 201",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262472",
            "telephone_number": "623-399-6825",
            "fax_number": "623-505-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARROWS",
        "first_name": "CRYSTAL",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "AZ",
            "license": "970809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "970809",
            "identifier": "AZ LICENSE",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212447",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "BARRAZA",
            "middle_name": "R",
            "prefix": "MISS",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.