Crystal Hackett, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71009900A Issued in IN

Practice address

679 E County Line Rd
Greenwood, IN 46143-1049

Phone

(317) 859-7222

Fax

(317) 859-7220

NPI assigned

Dec 26, 2019

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chackett11177@direct.franciscanalliance.org
• Direct secure messaging: urologyin@directaddress.net

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.

• Urology of Indiana L.L.C.

  • Urology Physician
  • Greenwood, IN
  • NPI 1487680518

  Nurse Practitioner

  Medicare reassignment NPD
• Urology of Indiana, L.L.C.

  • Customized Equipment (DME)
  • Indianapolis, IN
  • NPI 1740360379
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1760021661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 E COUNTY LINE RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431049",
            "telephone_number": "317-807-1266",
            "fax_number": "317-859-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 E COUNTY LINE RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431049",
            "telephone_number": "317-859-7222",
            "fax_number": "317-859-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKETT",
        "first_name": "CRYSTAL",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-26",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009900A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "677730",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "urologyin@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Urology of Indiana L.L.C.",
            "address_1": "679 E County Line Rd",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461431049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madison Gunderman
• Roxanne Lyn Gunning, PTA
• Kayla Guthrie
• Joe Gutzwiller
• Jerry Wayne Hack, LCSW, LMFT
• Stephanie Danielle Hadley
• Terrence D Haffner, MD
• David Hagan
• Ingrid Norma Haggstrom, PT
• Aliya Haider, M.D

• Nurse Practitioner in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.