Active NPI
Crystal R Middleton, MA, CCC-SLP
- Speech-Language Pathologist
- Oak Grove, LA
National Provider Identifier
1821187170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6081
- Practice address
- 208 Bonaire Dr
Oak Grove, LA 71263-7710 - Phone
- (318) 547-0572
- NPI assigned
- Oct 12, 2006
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6081 | LA | Primary |
Addresses
Primary practice location
208 Bonaire Dr
Oak Grove, LA 71263-7710
Mailing address
PO Box 14662
Monroe, LA 71207-4662
Phone (318) 547-0572
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6081 | LA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735171200000",
"number": "1821187170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 14662",
"city": "MONROE",
"state": "LA",
"postal_code": "712074662",
"telephone_number": "318-547-0572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 BONAIRE DR",
"city": "OAK GROVE",
"state": "LA",
"postal_code": "712637710",
"telephone_number": "318-547-0572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIDDLETON",
"first_name": "CRYSTAL",
"middle_name": "R",
"credential": "MA, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2024-12-26",
"certification_date": "2024-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "6081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Grove, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.