Individual provider Active NPI

Taylor Nicole Chrisman, PA-C

  • Physician Assistant
  • Grand Island, NE
National Provider Identifier
1912437815
Registry record updated May 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2135 Issued in NE
Practice address
810 N Diers Ave
Grand Island, NE 68803-4955
Phone
(308) 381-2224
NPI assigned
Jun 14, 2017
Last updated
May 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2135 NE
Physician Assistant 363A00000X 2135 NE Primary

Addresses

Primary practice location

810 N Diers Ave
Grand Island, NE 68803-4955

Mailing address

501 Road G
Henderson, NE 68371-8819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20170816001064 NE Practitioner - Physician Assistant 1254603905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

810 N Diers Ave
Grand Island, NE 68803-4955
Phone (308) 381-2224

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2135NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premise Health of Nevada Medical Hinitt P C Family Medicine CurrentSince Aug 9, 2017 Accepting new patients
Premise Health of Nevada Medical Hinitt PC CurrentSince Aug 9, 2017 Accepting new patients

Locations

16906 Collection Ctr Dr
Chicago, IL 60693

810 N Diers Ave
Grand Island, NE 68803
Phone (308) 381-2224

205 Millersprings Ct
Franklin, TN 37064
Phone (615) 468-5500

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.

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": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1912437815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 ROAD G",
            "city": "HENDERSON",
            "state": "NE",
            "postal_code": "683718819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 N DIERS AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034955",
            "telephone_number": "308-381-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISMAN",
        "first_name": "TAYLOR",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "2135",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.