Individual provider Active NPI

Reshae M Crawford, FNP

  • Family Nurse Practitioner
  • Rancho Mirage, CA
National Provider Identifier
1538779574
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95016053 Issued in CA
Practice address
35400 Bob Hope Dr Ste 209
Rancho Mirage, CA 92270-1774
Phone
(760) 202-0686
Fax
(760) 770-4563
NPI assigned
Aug 5, 2020
Last updated
Feb 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95016053 CA Primary
Registered Nurse 163W00000X 814600 CA

Addresses

Primary practice location

35400 Bob Hope Dr Ste 209
Rancho Mirage, CA 92270-1774

Mailing address

35400 Bob Hope Dr Ste 209
Rancho Mirage, CA 92270-1774
Phone (760) 202-0686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230113000398 CA Practitioner - Nurse Practitioner 3375930969 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
814600CAMDRegistered Nurse
95016053CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Syed F Azam Medical Associates Inc Current Accepting new patients
Emily Rekuc D.O., Inc. CurrentSince Dec 5, 2022 Accepting new patients

Locations

79440 Highway 111
Ste 105
La Quinta, CA 92253
Phone (760) 777-4067

35400 Bob Hope Dr
Ste 209
Rancho Mirage, CA 92270
Phone (760) 202-0686

Interoperability endpoints

  • Direct secure messaging: reshae.crawford.1@11678.direct.athenahealth.com

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": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1538779574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35400 BOB HOPE DR STE 209",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922701774",
            "telephone_number": "760-202-0686",
            "fax_number": "760-770-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35400 BOB HOPE DR STE 209",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922701774",
            "telephone_number": "760-202-0686",
            "fax_number": "760-770-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "RESHAE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95016053",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "814600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.