Individual provider Active NPI

Kathleen Isabel Crum, PHD

  • Psychologist
  • Indianapolis, IN
National Provider Identifier
1861000762
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20043371A Issued in IN
Practice address
1002 Wishard Blvd Ste 4110
Indianapolis, IN 46202-2872
Phone
(317) 944-8162
Fax
(317) 944-0609
NPI assigned
Jul 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20043371A IN
Psychologist 103T00000X 20043371A IN Primary

Addresses

Primary practice location

1002 Wishard Blvd Ste 4110
Indianapolis, IN 46202-2872

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcrum2@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200807000246 IN Practitioner - Clinical Psychologist 0042635088 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1002 Wishard Blvd
Ste 4110
Indianapolis, IN 46202
Phone (317) 274-6450

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: kcrum2@direct.iuhealth.org

Organizations & group practices 2

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": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1861000762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 WISHARD BLVD STE 4110",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022872",
            "telephone_number": "317-944-8162",
            "fax_number": "317-944-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUM",
        "first_name": "KATHLEEN",
        "middle_name": "ISABEL",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20043371A",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20043371A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcrum2@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1002 Wishard Blvd Ste 4110",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462022872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.