Individual provider Active NPI

Crystal Crowe, CCC-SLP

  • Speech-Language Pathologist
  • Tupelo, MS
National Provider Identifier
1972798189
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S3191 Issued in MS
Practice address
960 Commonwealth Blvd
Tupelo, MS 38804-9762
Phone
(662) 260-3798
Fax
(662) 260-3790
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X S3191 MS Primary

Addresses

Primary practice location

960 Commonwealth Blvd
Tupelo, MS 38804-9762

Mailing address

199 N Brookmoore Dr
Columbus, MS 39705-2024
Phone (662) 327-6705

Other names 1

  • Crystal Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141008001172 MS Practitioner - Qualified Speech Language Pathologist 6608096946 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Mississippi LLC Past Accepting new patients
Elite Physical Therapy Past Accepting new patients

Organizations & group practices 4

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": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1972798189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 N BROOKMOORE DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052024",
            "telephone_number": "662-327-6705",
            "fax_number": "662-869-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 COMMONWEALTH BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388049762",
            "telephone_number": "662-260-3798",
            "fax_number": "662-260-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWE",
        "first_name": "CRYSTAL",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.