Active NPI
Tabitha Crispin, RMA
- Nurse's Aide
- Jackson, OH
National Provider Identifier
1972287498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 501038891105
- Practice address
- 1631 Cutlip Rd
Jackson, OH 45640-8976 - Phone
- (740) 648-6986
- NPI assigned
- Jun 14, 2023
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 501038891105 | OH | Primary |
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 10090635 | OH |
Addresses
Primary practice location
1631 Cutlip Rd
Jackson, OH 45640-8976
Mailing address
1631 Cutlip Rd
Jackson, OH 45640-8976
Phone (740) 648-6986
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
- Registered Medical Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10090635 | OH | MD | Addiction Medicine (Family Medicine) Physician |
| 501038891105 | OH | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686700800000",
"number": "1972287498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 CUTLIP RD",
"city": "JACKSON",
"state": "OH",
"postal_code": "456408976",
"telephone_number": "740-648-6986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 CUTLIP RD",
"city": "JACKSON",
"state": "OH",
"postal_code": "456408976",
"telephone_number": "740-648-6986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRISPIN",
"first_name": "TABITHA",
"credential": "RMA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-14",
"last_updated": "2023-06-14",
"certification_date": "2023-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "OH",
"license": "501038891105",
"primary": true
},
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "OH",
"license": "10090635",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.