Individual provider Active NPI

Kristine Crouch, FNP

  • Family Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1699490748
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
858223 Issued in NV
Practice address
8985 S Pecos Rd Ste 4a
Henderson, NV 89074-7163
Phone
(702) 433-1332
NPI assigned
Oct 10, 2022
Last updated
Oct 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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 858223 NV Primary

Addresses

Primary practice location

8985 S Pecos Rd Ste 4a
Henderson, NV 89074-7163

Mailing address

322 Doe Run Cir
Henderson, NV 89012-2701
Phone (702) 575-5824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20221218000013 NV Practitioner - Nurse Practitioner 2860861630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8985 S Pecos Rd
Suite 4a
Henderson, NV 89074-7163
Phone (702) 433-1332

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
858223NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wikler Family Practice Associates Professional Corporation CurrentSince Jan 1, 2023 Accepting new patients

Locations

8985 S Pecos Rd
Ste 4A
Henderson, NV 89074
Phone (702) 433-1332

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1699490748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 DOE RUN CIR",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890122701",
            "telephone_number": "702-575-5824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8985 S PECOS RD STE 4A",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747163",
            "telephone_number": "702-433-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "KRISTINE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "858223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.