Individual provider Active NPI

Crystal Nichole Anderson, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Anchorage, AK
National Provider Identifier
1962775940
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PHAP1626 Issued in AK
Practice address
7701 Debarr Rd
Anchorage, AK 99504-1845
Phone
(907) 269-1733
Fax
(907) 269-1727
NPI assigned
Feb 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1626 AK
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PHAP1626 AK Primary

Addresses

Primary practice location

7701 Debarr Rd
Anchorage, AK 99504-1845

Mailing address

7701 Debarr Rd
Anchorage, AK 99504-1845
Phone (907) 269-1733

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
1626AKMDPharmacist
PHAP1626AKMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Fred Meyer Stores Inc Past Accepting new patients
Fred Meyer Stores Inc. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1962775940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 DEBARR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995041845",
            "telephone_number": "907-269-1733",
            "fax_number": "907-269-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 DEBARR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995041845",
            "telephone_number": "907-269-1733",
            "fax_number": "907-269-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CRYSTAL",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-21",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AK",
            "license": "1626",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AK",
            "license": "PHAP1626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.