Individual provider Active NPI

Jessica Crager

  • Family Nurse Practitioner
  • Pittsburg, KS
National Provider Identifier
1679103642
Registry record updated Jan 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-79232-122 Issued in KS
Practice address
2401 S Tucker Terr
Ste 1
Pittsburg, KS 66762
Phone
(620) 231-1650
NPI assigned
Jan 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-79232-122 KS Primary

Addresses

Primary practice location

2401 S Tucker Terr
Ste 1
Pittsburg, KS 66762

Mailing address

2401 S Tucker Terr
Ste 1
Pittsburg, KS 66762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20200511000777 KS Practitioner - Nurse Practitioner 2365871290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pittsburg Internal Medicine PAGroup PAC ID 9335032937, 2 clinicians

Practice addresses (Care Compare)

2401 S Tucker Ave
Suite 1
Pittsburg, KS 66762-6619
Phone (620) 231-1650

Hospital & facility affiliations

  • Mercy Hospital Pittsburg, Inc Hospital, Pittsburg, KS, CCN 170006
  • Girard Medical Center Hospital, Girard, KS, CCN 171376

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-79232-122KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pittsburg Internal Medicine, P.a. CurrentSince Apr 1, 2020 Accepting new patients

Locations

2401 S Tucker Ave
Ste 1
Pittsburg, KS 66762
Phone (620) 231-1650

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.

Hospital & facility affiliations 2

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": "1579305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579305600000",
    "number": "1679103642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 S TUCKER TERR",
            "address_2": "STE 1",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "66762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S TUCKER TERR",
            "address_2": "STE 1",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "66762",
            "telephone_number": "620-231-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAGER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-18",
        "last_updated": "2020-01-18",
        "certification_date": "2020-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-79232-122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburg, KS

Sources for this page

Verify at the official NPI Registry.