Individual provider Active NPI

Crystal Henry, AUD

  • Audiologist
  • Cleveland, OH
National Provider Identifier
1609432467
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A02189 Issued in OH
Practice address
11635 Euclid Ave
Cleveland, OH 44106-4319
Phone
(216) 231-8787
Fax
(216) 231-8787
NPI assigned
May 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A02189 OH Primary

Addresses

Primary practice location

11635 Euclid Ave
Cleveland, OH 44106-4319

Mailing address

11635 Euclid Ave
Cleveland, OH 44106-4319
Phone (216) 231-8787

Other identifiers 1

IdentifierTypeStateIssuer
0349245MedicaidOH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
A02189OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Hearing and Speech Center PastSince May 13, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1609432467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11635 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441064319",
            "telephone_number": "216-231-8787",
            "fax_number": "216-231-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11635 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441064319",
            "telephone_number": "216-231-8787",
            "fax_number": "216-231-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "CRYSTAL",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-16",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A02189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0349245",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.