Shasta Joy Crawford, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

301186 Issued in CA

Practice address

2835 Childress Dr
Anderson, CA 96007-3563

Phone

(530) 378-0998

Fax

(530) 378-2072

NPI assigned

Jun 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shasta Joy Fleming Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Farwest Rehabilitation, Inc

  • Specialist
  • Redding, CA
  • NPI 1861406100
  NPD (past)

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1780200154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 CHILDRESS DR",
            "city": "ANDERSON",
            "state": "CA",
            "postal_code": "960073563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 CHILDRESS DR",
            "city": "ANDERSON",
            "state": "CA",
            "postal_code": "960073563",
            "telephone_number": "530-378-0998",
            "fax_number": "530-378-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "SHASTA",
        "middle_name": "JOY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63683",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHASTA",
            "last_name": "FLEMING",
            "middle_name": "JOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Derrick A Cobb
• Compassion Pathway Behavioral Health LLC
• Chad Anthony Cooper Jr., DC
• Bruce D Court, LMFT
• Emily Cox
• Christina M Creeden, NP-C
• Jared Culver
• David Norman Cunningham
• Griffin Fredrick Dalske-Giarmona
• Daniel Murolo, D.D.S. a Professional Dental Corporation

• Physical Therapist in Anderson, CA
• Providers in Anderson, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.