Individual provider Active NPI

Catherine Crenshaw Richards, APRN

  • Adult Health Nurse Practitioner
  • Minnetonka, MN
National Provider Identifier
1851664908
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN176345 Issued in GA
Practice address
9900 Bren Rd E
Minnetonka, MN 55343-9664
Phone
(706) 424-9214
NPI assigned
Feb 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN176345 GA
Adult Health Nurse Practitioner 363LA2200X RN176345 GA Primary

Addresses

Primary practice location

9900 Bren Rd E
Minnetonka, MN 55343-9664

Mailing address

1044 Kalmia Cir
Evans, GA 30809-7233

Other names 1

  • Catherine Regina Crenshaw Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20140818002685 GA Practitioner - Nurse Practitioner 6305093139 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN176345GAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Center, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Au Medical Center, Inc CurrentSince Jan 1, 2018 Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1851664908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 KALMIA CIR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308097233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "706-424-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "CATHERINE",
        "middle_name": "CRENSHAW",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-21",
        "last_updated": "2020-09-10",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN176345",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN176345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "CRENSHAW",
            "middle_name": "REGINA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

Verify at the official NPI Registry.