Individual provider Active NPI

Erin Ashley Cruttenden, PT

  • Pediatric Physical Therapist
  • Lawrenceville, GA
National Provider Identifier
1982809174
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT009063 Issued in GA
Practice address
545 Old Norcross Road
Suite 100
Lawrenceville, GA 30046-3099
Phone
(678) 377-2833
Fax
(678) 377-2882
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT009063 GA Primary

Addresses

Primary practice location

545 Old Norcross Road
Suite 100
Lawrenceville, GA 30046-3099

Mailing address

2725 Briarfield Way
Lawrenceville, GA 30043-2347
Phone (678) 377-2833

Other identifiers 1

IdentifierTypeStateIssuer
574378030AMedicaidGA

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

LicenseStateTypeSpecialty
PT009063GAMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1982809174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 BRIARFIELD WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300432347",
            "telephone_number": "678-377-2833",
            "fax_number": "678-377-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 OLD NORCROSS ROAD",
            "address_2": "SUITE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463099",
            "telephone_number": "678-377-2833",
            "fax_number": "678-377-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUTTENDEN",
        "first_name": "ERIN",
        "middle_name": "ASHLEY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "PT009063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "574378030A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.