Individual provider Active NPI

Sherry Diane Crowder, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Angelo, TX
National Provider Identifier
1609057108
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
583085 Issued in TX
Practice address
244 N Magdalen St
San Angelo, TX 76903-5434
Phone
(325) 655-8965
Fax
(325) 658-5196
NPI assigned
Nov 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 583085 TX Primary

Addresses

Primary practice location

244 N Magdalen St
San Angelo, TX 76903-5434

Mailing address

244 N Magdalen St
San Angelo, TX 76903-5434
Phone (325) 655-8965

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
I20080318000235 TX Practitioner - Nurse Practitioner 5496831380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Concho Valley Center for Human AdvancementGroup PAC ID 7719936533, 7 clinicians

Practice addresses (Care Compare)

202 N Main St
San Angelo, TX 76903-4842
Phone 3256587750368

Hospital & facility affiliations

  • Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
583085TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Concho Valley Center for Human Advancement Psychiatric/Mental Health CurrentSince Nov 9, 2007 Accepting new patients
Concho Valley Center for Human Advancement Psychiatric/Mental Health CurrentSince Nov 9, 2007 Accepting new patients

Locations

1501 W Beauregard Ave
San Angelo, TX 76901
Phone (325) 658-7750

202 N Main St
San Angelo, TX 76903
Phone (325) 658-7750

244 N Magdalen St
San Angelo, TX 76903
Phone (325) 655-8965

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1609057108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 N MAGDALEN ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035434",
            "telephone_number": "325-655-8965",
            "fax_number": "325-658-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 N MAGDALEN ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035434",
            "telephone_number": "325-655-8965",
            "fax_number": "325-658-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWDER",
        "first_name": "SHERRY",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "583085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.