Individual provider Active NPI

Crystal Dawn Davison, APRN

  • Family Nurse Practitioner
  • Lee's Summit, MO
National Provider Identifier
1467728089
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2012006269 Issued in MO
Practice address
290 NE Tudor Rd
Lees Summit, MO 64086-5696
Phone
(816) 524-5522
Fax
(816) 524-4798
NPI assigned
Mar 28, 2012
Last updated
Jul 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-77807 KS
Family Nurse Practitioner 363LF0000X 2012006269 MO Primary

Addresses

Primary practice location

290 NE Tudor Rd
Lees Summit, MO 64086-5696

Mailing address

5101 College Blvd
Leawood, KS 66211-1614
Phone (816) 812-1682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120419000273 MO Practitioner - Nurse Practitioner 7719148626 Reassigns benefits to 1 organization
I20180110002456 KS Practitioner - Nurse Practitioner 7719148626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ascentist Physicians Group LLCGroup PAC ID 9335143759, 111 clinicians

Practice addresses (Care Compare)

1502 N Jefferson St
Carrollton, MO 64633-1948
Phone (816) 478-4200

4801 College Blvd
Leawood, KS 66211-1628
Phone (913) 721-3387

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.19 of 100Reported as group
Quality
72.61
Promoting interoperability
100
Improvement activities
30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2012006269MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascentist Physicians Group, LLC CurrentSince Dec 1, 2021 Accepting new patients

Locations

2300 Hutton Rd
Ste 106
Kansas City, KS 66109
Phone (913) 728-0386

2300 Hutton Rd
Ste 106107
Kansas City, KS 66109

4801 College Blvd
Ste 100
Leawood, KS 66211
Phone (913) 956-2200

4801 College Blvd
Ste 200
Leawood, KS 66211

4901 College Blvd
Leawood, KS 66211
Phone (816) 836-2200

4061 Indian Creek Pkwy
Overland Park, KS 66207
Phone (913) 323-4600

4061 Indian Creek Pkwy
Ste 350
Overland Park, KS 66207
Phone (816) 524-5522

4820 College Blvd
Ste A
Overland Park, KS 66211

5101 College Blvd
Overland Park, KS 66211

5701 W 119th St
Ste 220
Overland Park, KS 66209
Phone (816) 524-5522

6815 Frontage Rd
Ste A
Overland Park, KS 66204
Phone (913) 348-6725

4801 College Blvd
Shawnee Msn, KS 66211
Phone (913) 491-6451

1502 N Jefferson St
Carrollton, MO 64633
Phone (660) 542-1695

290 NE Tudor Rd
Lees Summit, MO 64086
Phone (816) 524-3280

4880 NE Goodview Cir
Lees Summit, MO 64064
Phone (816) 246-1456

Interoperability endpoints

  • Direct secure messaging: cdavison461195@direct.saint-lukes.org
  • Direct secure messaging: crystal.davison.1@12752.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1467728089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 COLLEGE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111614",
            "telephone_number": "816-812-1682",
            "fax_number": "816-524-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 NE TUDOR RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865696",
            "telephone_number": "816-524-5522",
            "fax_number": "816-524-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "CRYSTAL",
        "middle_name": "DAWN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-77807",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012006269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.