Individual provider Active NPI

Nicole P Crossley, LD

  • Registered Dietitian
  • Piedmont, OK
National Provider Identifier
1710244660
Registry record updated Apr 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1813 Issued in OK
Practice address
12021 NW 136TH Ter
Piedmont, OK 73078-8959
Phone
(405) 863-3622
NPI assigned
Apr 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1813 OK Primary

Addresses

Primary practice location

12021 NW 136TH Ter
Piedmont, OK 73078-8959

Mailing address

12021 NW 136TH Ter
Piedmont, OK 73078-8959
Phone (405) 863-3622

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

State licenses

LicenseStateTypeSpecialty
1813OKMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334620800000",
    "number": "1710244660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12021 NW 136TH TER",
            "city": "PIEDMONT",
            "state": "OK",
            "postal_code": "730788959",
            "telephone_number": "405-863-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 NW 136TH TER",
            "city": "PIEDMONT",
            "state": "OK",
            "postal_code": "730788959",
            "telephone_number": "405-863-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSLEY",
        "first_name": "NICOLE",
        "middle_name": "P",
        "credential": "LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-17",
        "last_updated": "2012-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "1813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piedmont, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.