Individual provider Active NPI

Crystal Killilea Ramos, PSYD

  • Clinical Neuropsychologist
  • Indianapolis, IN
National Provider Identifier
1730480658
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
20042520A Issued in IN
Practice address
10293 N Meridian St Ste 210
Indianapolis, IN 46290-1079
Phone
(317) 581-2292
Fax
(317) 581-2285
NPI assigned
Nov 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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
Clinical Neuropsychologist 103G00000X 20042520A IN Primary

Addresses

Primary practice location

10293 N Meridian St Ste 210
Indianapolis, IN 46290-1079

Mailing address

10293 N Meridian St
Ste 210
Indianapolis, IN 46290-1079
Phone (317) 278-5859

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
20042520AINMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730480658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10293 N MERIDIAN ST",
            "address_2": "STE 210",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901079",
            "telephone_number": "317-278-5859",
            "fax_number": "317-274-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10293 N MERIDIAN ST STE 210",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901079",
            "telephone_number": "317-581-2292",
            "fax_number": "317-581-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "CRYSTAL",
        "middle_name": "KILLILEA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IN",
            "license": "20042520A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.