Jacob C Crist

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11-06236 Issued in KS

Practice address

10600 Mastin St
Overland Park, KS 66212-5723

Phone

(913) 681-0606

Fax

(913) 338-1311

NPI assigned

Jul 2, 2019

Last updated

Jul 2, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Kansas School of Med (KC/Wich/Sal), 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Specialists in Sports and Orthopedic Rehabilitation LLCGroup PAC ID 8820259906, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Specialists in Sports and Orthopedic Rehabilitation LLC

  • Physical Therapist
  • Overland Park, KS
  • NPI 1134493075
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1982266714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741331",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741331",
            "telephone_number": "913-469-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 MASTIN ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662125723",
            "telephone_number": "913-681-0606",
            "fax_number": "913-338-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIST",
        "first_name": "JACOB",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-06236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creative Mind Health, LLC
• Creative Solutions Consulting and Advocacy LLC
• Creighton Gallagher, DDS LLC (Overland Park Family Dental)
• Kelly Crimmins
• Crimson Pain Management, LLC
• Arian Critchfield, OTR/L
• Kelly Ann Croci, PA
• Kent Crockett
• Saffron Anne Croker
• Gracielle Cromwell, FNP-C

• Physical Therapist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.