Crystal Ruddell Meredith, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA.200237 Issued in LA

Practice address

187 Ninth Street
Jena, LA 71342

Phone

(318) 992-9296

Fax

(318) 992-9125

NPI assigned

Oct 8, 2008

Last updated

Oct 14, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lasalle Parish Hospital Service Dist No1

  dba Hardtner Medical Center

  • Critical Access Hospital
  • Olla, LA
  • NPI 1639263189
  Medicare reassignment
• Lasalle Parish Hospital Service District #1

  dba Hardtner Medical Center

  • Critical Access Hospital
  • Olla, LA
  • NPI 1184815466
  Medicare reassignment
• Lasalle Parish Hospital Service District #1

  dba Hardtner Medical Clinic

  • Rural Health Clinic/Center
  • Olla, LA
  • NPI 1053415745
  NPD
• Lasalle Parish Hospital Service District #1

  dba Hardtner Family Clinic

  • Rural Health Clinic/Center
  • Urania, LA
  • NPI 1821401241
  NPD (past)

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1881845824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 NINTH STREET",
            "address_2": "P.O. BOX 2780",
            "city": "JENA",
            "state": "LA",
            "postal_code": "713422780",
            "telephone_number": "318-992-9200",
            "fax_number": "318-992-9245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 NINTH STREET",
            "city": "JENA",
            "state": "LA",
            "postal_code": "71342",
            "telephone_number": "318-992-9296",
            "fax_number": "318-992-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEREDITH",
        "first_name": "CRYSTAL",
        "middle_name": "RUDDELL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "PA.200237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Margaret Elizabeth McCarty, B.A. ELEMENTARY ED.
• Sharla McCarty, MA. CCC-SLP
• Melissa Etage Manuel, D.C., LLC
• Sandra Melvin
• Mentally Fit Behavioral Health LLC
• Metamorphosis Mental Health, LLC
• Mid State Orthopaedic & Sports Medicine Center LLC
• Reba Miller, LPN
• Sarah Molan
• Glenda Pritchard Parker

• Medical Physician Assistant in Jena, LA
• Providers in Jena, LA by specialty
• Medical Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.