Chad Luckett Crossley, PT, DPT, MS, OCS, AT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9743PT Issued in AZ

Practice address

90 Hope Dr
Mountain Home Afb, ID 83648

Phone

(412) 432-3700

NPI assigned

Aug 1, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Mountain Home Physical Therapy, PC

  • Physical Therapy Clinic/Center
  • Mountain Home, ID
  • NPI 1134251507

  ID

  Medicare reassignment Care Compare group NPD

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain Home Physical Therapy PC 2 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1457517112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 NE TANAGER ST",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836474801",
            "telephone_number": "412-478-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 HOPE DR",
            "city": "MOUNTAIN HOME AFB",
            "state": "ID",
            "postal_code": "83648",
            "telephone_number": "412-432-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSLEY",
        "first_name": "CHAD",
        "middle_name": "LUCKETT",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, MS, OCS, AT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-01",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT019425",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "9743PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Michael Christy, D.D.S
• Charlie Ann Collenborne, M.D.
• Noah Comstock
• Janette Sue Cooke
• Lauren Christine Crim
• Derek J Dutson, D.M.D.
• Le Ann Marie Egan
• Zane Elliott, IDMT
• David J Emert
• Anthony Ewell-Kollmann, DMD

• All providers in Mountain Home Afb, ID
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; 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.