Active NPI
Crystal Gilham
- Physical Therapy Assistant
- Fort Smith, AR
National Provider Identifier
1811879273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA4820
- Practice address
- 3304 S M St
Fort Smith, AR 72903-2903 - Phone
- (479) 785-4677
- NPI assigned
- Jul 24, 2025
- Last updated
- Jul 24, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA4820 | AR | Primary |
Addresses
Primary practice location
3304 S M St
Fort Smith, AR 72903-2903
Mailing address
3602 Fairhaven CV
Greenwood, AR 72936-6849
Phone (479) 252-8485
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA4820 | AR | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753315200000",
"number": "1811879273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3602 FAIRHAVEN CV",
"city": "GREENWOOD",
"state": "AR",
"postal_code": "729366849",
"telephone_number": "479-252-8485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3304 S M ST",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729032903",
"telephone_number": "479-785-4677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILHAM",
"first_name": "CRYSTAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-07-24",
"last_updated": "2025-07-24",
"certification_date": "2025-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AR",
"license": "PTA4820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.