Individual provider Active NPI

Crystal Gaile Tucker

  • Certified Registered Nurse Anesthetist
  • Longview, TX
National Provider Identifier
1699001982
Registry record updated May 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN608141 Issued in PA
Practice address
3637 US Highway 259 N Apt 801
Longview, TX 75605-7780
Phone
(870) 814-1980
NPI assigned
Oct 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN608141 PA Primary

Addresses

Primary practice location

3637 US Highway 259 N Apt 801
Longview, TX 75605-7780

Mailing address

3637 US Highway 259 N Apt 801
Longview, TX 75605-7780
Phone (870) 814-1980

Other names 1

  • Crystal Gaile Greenwalt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150826000135 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5294874350 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia III PAGroup PAC ID 0042630501, 393 clinicians

Practice addresses (Care Compare)

2901 4TH St
Longview, TX 75605-5128
Phone (903) 232-3606

3315 S Alameda St
Corpus Christi, TX 78411-1820
Phone (214) 687-0001

PO Box
Suite 222262
Dallas, TX 75222-2262

Hospital & facility affiliations

  • Longview Regional Medical Center Hospital, Longview, TX, CCN 450702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia III PA Nurse Anesthetist, Certified Registered CurrentSince Jun 12, 2021 Accepting new patients
Longview Medical Center LP Nurse Anesthetist, Certified Registered CurrentSince Jul 22, 2015 Accepting new patients
Longview Medical Center LP CurrentSince Jul 22, 2015 Accepting new patients
Texas Ams PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2020 Accepting new patients

Locations

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

1416 George Dieter Dr
El Paso, TX 79936
Phone (877) 822-6281

1815 N Stanton St
El Paso, TX 79902
Phone (915) 533-8412

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

Organizations & group practices 4

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 1

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": "1256169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432512000000",
    "number": "1699001982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3637 US HIGHWAY 259 N APT 801",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057780",
            "telephone_number": "870-814-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 US HIGHWAY 259 N APT 801",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057780",
            "telephone_number": "870-814-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CRYSTAL",
        "middle_name": "GAILE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-22",
        "last_updated": "2015-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN608141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "GREENWALT",
            "middle_name": "GAILE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.