Active NPI
Jill S Crabtree, PA-C
- Physician Assistant
- Fort Thomas, KY
National Provider Identifier
1912918657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA570
- Practice address
- 85 N Grand Ave
Fort Thomas, KY 41075-1793 - Phone
- (859) 572-3618
- Fax
- (859) 572-2326
- NPI assigned
- Aug 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10003191A | IN | |
| Physician Assistant | 363A00000X | PA570 | KY | Primary |
Addresses
Primary practice location
85 N Grand Ave
Fort Thomas, KY 41075-1793
Mailing address
PO Box 18667
Erlanger, KY 41018-0667
Phone (859) 572-3617
Other practice location 1
4900 Houston Rd
Florence, KY 41042-4824
Phone (859) 212-5441
Other practice location 2
600 Wilson Creek Rd
Lawrenceburg, IN 47025-2751
Phone (812) 537-1010
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300048421 | Medicaid | IN | |
| P00813820 | Other | KY | RAILROAD MEDICARE |
| 0221879 | Medicaid | OH | |
| 95000501 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 93.13 of 100
- Quality
- 89.38
- Improvement activities
- 40
- Cost
- 79.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1912918657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18667",
"city": "ERLANGER",
"state": "KY",
"postal_code": "410180667",
"telephone_number": "859-572-3617",
"fax_number": "859-572-2326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 N GRAND AVE",
"city": "FORT THOMAS",
"state": "KY",
"postal_code": "410751793",
"telephone_number": "859-572-3618",
"fax_number": "859-572-2326"
}
],
"practiceLocations": [
{
"address_1": "4900 Houston Rd",
"address_purpose": "LOCATION",
"city": "Florence",
"state": "KY",
"postal_code": "410424824",
"country_code": "US",
"telephone_number": "859-212-5441",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "600 Wilson Creek Rd",
"address_purpose": "LOCATION",
"city": "Lawrenceburg",
"state": "IN",
"postal_code": "470252751",
"country_code": "US",
"telephone_number": "812-537-1010",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CRABTREE",
"first_name": "JILL",
"middle_name": "S",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-10",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10003191A",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA570",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300048421",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00813820",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0221879",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "95000501",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Thomas, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.