Individual provider Active NPI

Crystal Lynn Landgraf, FNP-BC

  • Family Nurse Practitioner
  • Rockport, TX
National Provider Identifier
1518632553
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1049983 Issued in TX
Practice address
442 Spanishwoods Dr
Rockport, TX 78382-9662
Phone
(361) 205-2205
NPI assigned
Aug 11, 2021
Last updated
Aug 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1049983 TX Primary

Addresses

Primary practice location

442 Spanishwoods Dr
Rockport, TX 78382-9662

Mailing address

PO Box 192
Ingleside, TX 78362-0192
Phone (361) 205-2205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20241119001846 TX Practitioner - Nurse Practitioner 4082149745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shea Physical Therapy Specialists LLCGroup PAC ID 6204245194, 194 clinicians

Practice addresses (Care Compare)

5440 Everhart Rd
Suite 1
Corpus Christi, TX 78411-4838
Phone (361) 994-5224

5917 Crosstown Epwy
SH 286
Corpus Christi, TX 78417-3504
Phone 3618541454113

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Associates of Corpus Christi CurrentSince Dec 1, 2024 Accepting new patients
Orthopedic Associates of Corpus Christi CurrentSince Dec 1, 2024 Accepting new patients

Locations

5917 Crosstown Expy
Corpus Christi, TX 78417
Phone 3618540811 ext. 113

5917 Crosstown Expy
#286
Corpus Christi, TX 78417
Phone (361) 854-1454

Interoperability endpoints

  • Direct secure messaging: crystal.landgraf.1@15288.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1518632553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 192",
            "city": "INGLESIDE",
            "state": "TX",
            "postal_code": "783620192",
            "telephone_number": "361-205-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 SPANISHWOODS DR",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783829662",
            "telephone_number": "361-205-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDGRAF",
        "first_name": "CRYSTAL",
        "middle_name": "LYNN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1049983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockport, TX

Sources for this page

Verify at the official NPI Registry.