Crystal King, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05008563A Issued in IN

Practice address

5949 W Raymond St
Indianapolis, IN 46241-4348

Phone

(317) 390-5599

Fax

(317) 486-2189

NPI assigned

Mar 2, 2006

Last updated

Aug 14, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Crystal Burrous Former name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advanced Physical Therapy, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Indianapolis, IN
  • NPI 1316940505
  Medicare reassignment NPD
• Advanced Physical Therapy, LLC

  • Durable Medical Equipment & Medical Supplies
  • Indianapolis, IN
  • NPI 1700595089

  Physical Therapist

  NPD
• Physical Therapy Associates of Orange Park, Inc

  dba Progressive Step Rehab of Orange Park

  • Physical Therapy Clinic/Center
  • Fleming Island, FL
  • NPI 1508883018

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471132800000",
    "number": "1740257260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5949 W RAYMOND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462414348",
            "telephone_number": "317-390-5599",
            "fax_number": "317-486-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "CRYSTAL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2016-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05008563A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ID",
            "identifier": "000000372346",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200526800",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "BURROUS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Nicole King, RBT
• Audrianna Nicole King, M.A, BCBA
• Brandon King
• Bryant Alan King, M.D.
• Catherine Scott King, M.D.
• Danelle Jean King, MSW, LCSW
• Devera King
• Donald G King, MD
• George Clayton King
• Hannah King

• Physical Therapist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.