Active NPI
Erin McCulloch Crisp, PAC
- Medical Physician Assistant
- Lebanon, TN
National Provider Identifier
1487610069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA0000001315
- Practice address
- 1407 W Baddour Pkwy
Lebanon, TN 37087-2513 - Phone
- (615) 444-6203
- Fax
- (615) 444-6252
- NPI assigned
- Apr 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA0000001315 | TN | Primary |
Addresses
Primary practice location
1407 W Baddour Pkwy
Lebanon, TN 37087-2513
Mailing address
1407 W Baddour Pkwy
Lebanon, TN 37087-2513
Phone (615) 444-6203
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA0000001315 | TN | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358899200000",
"number": "1487610069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1407 W BADDOUR PKWY",
"city": "LEBANON",
"state": "TN",
"postal_code": "370872513",
"telephone_number": "615-444-6203",
"fax_number": "615-444-6252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1407 W BADDOUR PKWY",
"city": "LEBANON",
"state": "TN",
"postal_code": "370872513",
"telephone_number": "615-444-6203",
"fax_number": "615-444-6252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRISP",
"first_name": "ERIN",
"middle_name": "MCCULLOCH",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-24",
"last_updated": "2013-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TN",
"license": "PA0000001315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.