Individual provider Active NPI

Crystal Rose Thompson, CRNA

  • Certified Registered Nurse Anesthetist
  • Lakewood, CO
National Provider Identifier
1912342932
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0990730 Issued in CO
Practice address
3333 S Wadsworth Blvd Unit D100
Lakewood, CO 80227-5117
Phone
(303) 205-1090
Fax
(303) 205-5534
NPI assigned
May 3, 2013
Last updated
Apr 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0990730 CO Primary

Addresses

Primary practice location

3333 S Wadsworth Blvd Unit D100
Lakewood, CO 80227-5117

Mailing address

1940 Denver West Dr Apt 524
Golden, CO 80401-3160
Phone (208) 890-4686

Other identifiers 1

IdentifierTypeStateIssuer
56674376MedicaidCO

Other names 1

  • Crystal Rose Poppke Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130716000217 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991945958 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
0990730COMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 8, 2020 Accepting new patients
Arapahoe Gastroenterology Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 12, 2016 Accepting new patients
Colorado Personnel Resources Inc Past Accepting new patients

Locations

7000 W Colfax Ave
Lakewood, CO 80214
Phone (303) 671-5553

1001 Southpark Dr
Littleton, CO 80120
Phone (303) 531-5724

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

NPI Registry JSON

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1912342932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 DENVER WEST DR APT 524",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804013160",
            "telephone_number": "208-890-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S WADSWORTH BLVD UNIT D100",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802275117",
            "telephone_number": "303-205-1090",
            "fax_number": "303-205-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CRYSTAL",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-03",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "0990730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56674376",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "POPPKE",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.