Individual provider Active NPI

Gina M. Crusor-Price, FNP-BC

  • Nurse Practitioner
  • Highland, IN
National Provider Identifier
1487608428
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71014056A Issued in IN
Practice address
9008 Indianapolis Blvd
Highland, IN 46322-2501
Phone
(219) 513-8923
Fax
(219) 513-8941
NPI assigned
May 22, 2006
Last updated
Jun 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71014056A IN Primary

Addresses

Primary practice location

9008 Indianapolis Blvd
Highland, IN 46322-2501

Mailing address

17112 California Ave
Hazel Crest, IL 60429-1118
Phone (708) 253-8205

Other identifiers 1

IdentifierTypeStateIssuer
200132000MedicaidIN

Other names 1

  • Gina M. Crusor-Price Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sanjay Patel, LLC CurrentSince Oct 19, 2023 Accepting new patients
Aesquivel Professional Corporation PastSince Jul 2, 2023 Accepting new patients

Locations

9008 Indianapolis Blvd
Highland, IN 46322
Phone (219) 513-8923

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, 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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1487608428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17112 CALIFORNIA AVE",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604291118",
            "telephone_number": "708-253-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9008 INDIANAPOLIS BLVD",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463222501",
            "telephone_number": "219-513-8923",
            "fax_number": "219-513-8941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUSOR-PRICE",
        "first_name": "GINA",
        "middle_name": "M.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71014056A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200132000",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "CRUSOR-PRICE",
            "middle_name": "M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Highland, IN

Sources for this page

Verify at the official NPI Registry.