Active NPI
Diane R Crisman, M.A.T. C.C.C.-SP
- Speech-Language Pathologist
- Fremont, IN
National Provider Identifier
1508955907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22000997A
- Practice address
- 401 South Broad St., Suite a
Fremont, IN 46737-0774 - Phone
- (260) 495-9098
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 22000997A | IN | Primary |
Addresses
Primary practice location
401 South Broad St., Suite a
Fremont, IN 46737-0774
Mailing address
PO Box D
Fremont, IN 46737-0774
Phone (260) 495-9098
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22000997A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1508955907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX D",
"city": "FREMONT",
"state": "IN",
"postal_code": "467370774",
"telephone_number": "260-495-9098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 SOUTH BROAD ST., SUITE A",
"city": "FREMONT",
"state": "IN",
"postal_code": "467370774",
"telephone_number": "260-495-9098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRISMAN",
"first_name": "DIANE",
"middle_name": "R",
"credential": "M.A.T. C.C.C.-SP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22000997A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.