NPIMap

Individual provider Active NPI

Crystal Dawn Tucker, NURSE PRACTITIONER

  • Gerontology Nurse Practitioner
  • Grand Junction, CO
National Provider Identifier
1821838665
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APN.0999761-NP Issued in CO
Practice address
750 Wellington Ave
Grand Junction, CO 81501-6132
Phone
(702) 987-5009
NPI assigned
May 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APN.0999761-NP CO Primary

Addresses

Primary practice location

750 Wellington Ave
Grand Junction, CO 81501-6132

Mailing address

750 Wellington Ave
Grand Junction, CO 81501-6132
Phone (970) 298-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250219003673 CO Practitioner - Nurse Practitioner 9638699754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intermountain Medical Group Grand Junction, LLCGroup PAC ID 3779707856, 297 clinicians

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

750 Wellington Ave
Grand Junction, CO 81501-6132

Hospital & facility affiliations

  • Intermountain Health St. Mary'S Regional Hospital Hospital, Grand Junction, CO, CCN 060023
  • Family Health West Hospital Hospital, Fruita, CO, CCN 061302
  • Memorial Hospital, the Hospital, Craig, CO, CCN 061314
  • Montrose Regional Health Hospital, Montrose, CO, CCN 060006
  • Delta County Memorial Hospital Hospital, Delta, CO, CCN 060071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Dec 15, 2024 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Dec 15, 2024 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Current Accepting new patients
St Mary'S Hospital and Medical Center, Inc Past Accepting new patients
St Mary'S Hospital and Medical Center, Inc Past Accepting new patients

Locations

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

750 Wellington Ave
Grand Junction, CO 81501
Phone (970) 244-2457

Organizations & group practices 5

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1821838665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 WELLINGTON AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016132",
            "telephone_number": "970-298-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WELLINGTON AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016132",
            "telephone_number": "702-987-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CRYSTAL",
        "middle_name": "DAWN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "APN.0999761-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.