Active NPI
Crystal Rose Street, AU.D.
- Audiologist
- Indianapolis, IN
National Provider Identifier
1972801504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 23002486A
- Practice address
- 1200 E 42ND St
Indianapolis, IN 46205-2004 - Phone
- (317) 941-4637
- Fax
- (317) 920-6350
- NPI assigned
- Mar 7, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 23002486A | IN | Primary |
Addresses
Primary practice location
1200 E 42ND St
Indianapolis, IN 46205-2004
Mailing address
1200 E 42ND St
Indianapolis, IN 46205-2004
Phone (317) 941-4637
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23002486A | IN | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana School for the Deaf | 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 and National Provider Directory roles.
-
- Local Education Agency (LEA)
- Indianapolis, IN
- NPI 1699837609
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299456000000",
"number": "1972801504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 E 42ND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462052004",
"telephone_number": "317-941-4637",
"fax_number": "317-920-6350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 E 42ND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462052004",
"telephone_number": "317-941-4637",
"fax_number": "317-920-6350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STREET",
"first_name": "CRYSTAL",
"middle_name": "ROSE",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-07",
"last_updated": "2011-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IN",
"license": "23002486A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.