Individual provider Active NPI

Luann Green Crissman, RN

  • Registered Nurse
  • Greensboro, NC
National Provider Identifier
1891815296
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
125493 Issued in NC
Practice address
1203 Maple St
Greensboro, NC 27405-6910
Phone
(336) 641-7777
Fax
(336) 641-6971
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 125493 NC Primary

Addresses

Primary practice location

1203 Maple St
Greensboro, NC 27405-6910

Mailing address

4712 Clifton Park Dr
Jamestown, NC 27282-8927
Phone (336) 880-0928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
125493NCMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891815296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 CLIFTON PARK DR",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272828927",
            "telephone_number": "336-880-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 MAPLE ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056910",
            "telephone_number": "336-641-7777",
            "fax_number": "336-641-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISSMAN",
        "first_name": "LUANN",
        "middle_name": "GREEN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "125493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.