Individual provider Active NPI

Natalie Marie Crandall, FNP-C

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1912424409
Registry record updated Aug 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017019299 Issued in MO
Practice address
3920 Hampton Ave
Saint Louis, MO 63109-1401
Phone
(844) 776-7200
NPI assigned
Aug 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2017

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 2017019299 MO Primary

Addresses

Primary practice location

3920 Hampton Ave
Saint Louis, MO 63109-1401

Mailing address

1506 Ivy Hill Cir
Hillsboro, MO 63050-4661
Phone (314) 609-1058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20191002002329 MO Practitioner - Nurse Practitioner 5294065322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Oncology LLCGroup PAC ID 1153446471, 30 clinicians

Practice addresses (Care Compare)

1350 US Hwy 61
Festus, MO 63028-4124
Phone (636) 931-3655

Hospital & facility affiliations

  • Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2017019299MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oncology, LLC CurrentSince Sep 23, 2019 Accepting new patients
Mercy Hospital Jefferson Past Accepting new patients

Locations

1350 US Highway 61
Crystal Cty, MO 63028
Phone (636) 931-3655

607 S New Ballas Rd
Ste 33
Saint Louis, MO 63141
Phone (314) 251-4400

901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500

Interoperability endpoints

  • Direct secure messaging: ncrandall1034388@directc.mercy.net

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.

Hospital & facility affiliations 1

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": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503532800000",
    "number": "1912424409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 IVY HILL CIR",
            "city": "HILLSBORO",
            "state": "MO",
            "postal_code": "630504661",
            "telephone_number": "314-609-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 HAMPTON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631091401",
            "telephone_number": "844-776-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "NATALIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2017-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017019299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.