Active NPI
Douglas Crisp
- Psychiatry Physician
- Grass Valley, CA
National Provider Identifier
1659494011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G77557
- Practice address
- 500 Crown Point Cir
Suite 120
Grass Valley, CA 95945-9514 - Phone
- (530) 265-1437
- NPI assigned
- Apr 9, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G77557 | CA | Primary |
Addresses
Primary practice location
500 Crown Point Cir
Suite 120
Grass Valley, CA 95945-9514
Mailing address
500 Crown Point Cir
Suite 120
Grass Valley, CA 95945-9514
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
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659494011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 CROWN POINT CIR",
"address_2": "SUITE 120",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959459514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 CROWN POINT CIR",
"address_2": "SUITE 120",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959459514",
"telephone_number": "530-265-1437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRISP",
"first_name": "DOUGLAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G77557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.