NPIMap

Individual provider Active NPI

Krista Crump, PA STUDENT

  • Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1689239030
Registry record updated Aug 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11950468-1206 Issued in UT
Practice address
1413 Clementine CT
Fort Collins, CO 80526-4210
Phone
(801) 824-6867
NPI assigned
May 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 11950468-1206 UT Primary

Addresses

Primary practice location

1413 Clementine CT
Fort Collins, CO 80526-4210

Mailing address

34 500 E
Salt Lake City, UT 84102
Phone (801) 824-6867

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL https://acueastwest.com
Direct Messaging Address KCRUMP586349@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220117000100 UT Practitioner - Physician Assistant 4082006408 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0001

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 587-6336

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.61 of 100Reported as group
Quality
93.24
Promoting interoperability
100
Improvement activities
40
Cost
45.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11950468-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Oct 13, 2021 Accepting new patients
University of Utah Specialty Services CurrentSince Jul 15, 2022 Accepting new patients
Ihc Health Services Inc CurrentSince Oct 13, 2021 Accepting new patients
University of Utah Specialty Services CurrentSince Jul 15, 2022 Accepting new patients
University of Utah Specialty Services Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 7

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 3

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": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661644800000",
    "number": "1689239030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 500 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84102",
            "telephone_number": "801-824-6867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 CLEMENTINE CT",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805264210",
            "telephone_number": "801-824-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMP",
        "first_name": "KRISTA",
        "credential": "PA STUDENT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-01",
        "last_updated": "2022-08-28",
        "certification_date": "2022-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "11950468-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://acueastwest.com",
            "affiliation": "N",
            "address_1": "34 500 E",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "84102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KCRUMP586349@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.