Individual provider Active NPI

Ali Crawford, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Potts Camp, MS
National Provider Identifier
1861874182
Registry record updated Apr 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R882698 Issued in MS
Practice address
3 Reids Ave
Potts Camp, MS 38659-8298
Phone
(662) 333-4333
NPI assigned
Jun 23, 2015
Last updated
Apr 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R882698 MS Primary

Addresses

Primary practice location

3 Reids Ave
Potts Camp, MS 38659-8298

Mailing address

3 Reids Ave
Potts Camp, MS 38659-8298
Phone (662) 333-4333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20151110002110 MS Practitioner - Nurse Practitioner 8820306467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Potts Camp Family Medical ClinicGroup PAC ID 5092903310, 2 clinicians

Practice addresses (Care Compare)

3 Reids Ave
Potts Camp, MS 38659-8298
Phone (662) 333-4333

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R882698MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Archipoimen PLLC CurrentSince Dec 13, 2024 Accepting new patients
Potts Camp Family Medical Clinic Family CurrentSince Jul 18, 2015 Accepting new patients

Locations

2670 McIngvale Rd
Ste H
Hernando, MS 38632
Phone (662) 429-4988

3 Reids Ave
Potts Camp, MS 38659
Phone (662) 333-4333

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460160000000",
    "number": "1861874182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 REIDS AVE",
            "city": "POTTS CAMP",
            "state": "MS",
            "postal_code": "386598298",
            "telephone_number": "662-333-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 REIDS AVE",
            "city": "POTTS CAMP",
            "state": "MS",
            "postal_code": "386598298",
            "telephone_number": "662-333-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "ALI",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2016-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R882698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potts Camp, MS

Sources for this page

Verify at the official NPI Registry.