Individual provider Active NPI

Rebecca Erin Crank, PA-C

  • Physician Assistant
  • Colorado Springs, CO
National Provider Identifier
1952414872
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0003975 Issued in CO
Practice address
525 Bob Peters GRV Ste 202
Colorado Springs, CO 80909-4533
Phone
(719) 365-6568
Fax
(719) 365-6317
NPI assigned
Aug 16, 2006
Last updated
Aug 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3975 CO
Medical Physician Assistant 363AM0700X 3477 AZ
Physician Assistant 363A00000X PA.0003975 CO Primary

Addresses

Primary practice location

525 Bob Peters GRV Ste 202
Colorado Springs, CO 80909-4533

Mailing address

10240 Park Meadows Dr
Lone Tree, CO 80124-5425
Phone (303) 338-4545

Other practice location 1

4050 Briargate Pkwy Ste C1150
Colorado Springs, CO 80920-7815
Phone (719) 365-6568

Other practice location 2

10240 Park Meadows Dr
Lone Tree, CO 80124-5425
Phone (303) 338-4545

Other identifiers 4

IdentifierTypeStateIssuer
025016OtherCOKAISER COMMERCIAL NUMBER
307093MedicaidAZ
P00623803OtherAZRAILROAD MEDICARE
49035045MedicaidCO

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0003975COMDPhysician Assistant
3477AZMDMedical Physician Assistant
3975COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Internists PC Past Accepting new patients

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, 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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1952414872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10240 PARK MEADOWS DR",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245425",
            "telephone_number": "303-338-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 BOB PETERS GRV STE 202",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809094533",
            "telephone_number": "719-365-6568",
            "fax_number": "719-365-6317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4050 Briargate Pkwy Ste C1150",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809207815",
            "country_code": "US",
            "telephone_number": "719-365-6568",
            "fax_number": "719-365-6317",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10240 Park Meadows Dr",
            "address_purpose": "LOCATION",
            "city": "Lone Tree",
            "state": "CO",
            "postal_code": "801245425",
            "country_code": "US",
            "telephone_number": "303-338-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRANK",
        "first_name": "REBECCA",
        "middle_name": "ERIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "3975",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3477",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0003975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "025016",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "307093",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00623803",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49035045",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.