Individual provider Active NPI

Brandy Katherine Crawford, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Richmond Hill, GA
National Provider Identifier
1619608114
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN251862 Issued in GA
Practice address
10393 Ford Avenue
Building C, Suite 2C
Richmond Hill, GA 31324
Phone
(912) 445-4854
Fax
(912) 335-3490
NPI assigned
Jun 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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 RN251862 GA Primary

Addresses

Primary practice location

10393 Ford Avenue
Building C, Suite 2C
Richmond Hill, GA 31324

Mailing address

160 Blue Lake St
Richmond Hill, GA 31324-4435
Phone (601) 896-2102

Other names 1

  • Brandy Katherine Crawford Professional name

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
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN251862GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bloom Behavioral Health LLC CurrentSince Jul 21, 2024 Accepting new patients
Georgia Outreach, LLC PastSince Jun 1, 2022 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1619608114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BLUE LAKE ST",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313244435",
            "telephone_number": "601-896-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10393 FORD AVENUE",
            "address_2": "BUILDING C, SUITE 2C",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "31324",
            "telephone_number": "912-445-4854",
            "fax_number": "912-335-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "BRANDY",
        "middle_name": "KATHERINE",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN251862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "CRAWFORD",
            "middle_name": "KATHERINE",
            "credential": "MSN, APRN, PMHNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Richmond Hill, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.