Individual provider Active NPI

Crystal Mae Brown, APN

  • Nurse Practitioner
  • Greenville, IL
National Provider Identifier
1508260761
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209011649 Issued in IL
Practice address
200 Health Care Dr
Greenville, IL 62246-1154
Phone
(618) 664-1230
NPI assigned
Oct 17, 2014
Last updated
May 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2019

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 209011649 IL Primary

Addresses

Primary practice location

200 Health Care Dr
Greenville, IL 62246-1154

Mailing address

4500 Memorial Drive-
Medical Affairs
Belleville, IL 62226
Phone (618) 257-4644

Other practice location 1

4500 Memorial Drive-
Medical Affairs
Belleville, IL 62226
Phone (618) 257-4644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150224001880 IL Practitioner - Nurse Practitioner 3577889237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Anthonys Way
Alton, IL 62002-4568
Phone (618) 465-2571

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.63
Improvement activities
40
Cost
81.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209011649ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-Illinois Hospitalists CurrentSince Jan 1, 2015 Accepting new patients
Cep America-Illinois Hospitalists CurrentSince Jan 1, 2015 Accepting new patients
Cep America-Illinois Hospitalists, LLP Current Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1508260761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DRIVE-",
            "address_2": "MEDICAL AFFAIRS",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-257-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HEALTH CARE DR",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622461154",
            "telephone_number": "618-664-1230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Memorial Drive-",
            "address_2": "Medical Affairs",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "62226",
            "country_code": "US",
            "telephone_number": "618-257-4644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CRYSTAL",
        "middle_name": "MAE",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209011649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, IL

Sources for this page

Verify at the official NPI Registry.