CRYSTAL HACKETT (NPI# 1760021661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760021661 |
| Entity Type | Individual |
| Full Name | CRYSTAL HACKETT |
| Credential | NP-C |
| Practice Address |
679 E County Line Rd Greenwood IN 46143-1049 |
| Practice Telephone | 3178597222 |
| Practice Fax Number | 3178597220 |
| Mailing Telephone | 3178071241 |
| Mailing Fax Number | 3178594269 |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2020-03-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 71009900A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | GROUP PTAN | 677730 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174131965 | Crystal Carin Hackett | Marriage & Family Therapist | 1525 W David Ave, Chillicothe, IL 61523-1937 | 2020-07-17 |
| Street Address |
679 E COUNTY LINE RD |
| City | GREENWOOD |
| State | IN |
| Zip Code | 46143-1049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942209184 | Kristian Hale Jensen | Physician Assistant | 679 E County Line Rd, Greenwood, IN 46143-1049 | 2005-07-19 |
| 1285184440 | Urology of Indiana, LLC | Durable Medical Equipment & Medical Supplies | 679 E County Line Rd, Greenwood, IN 46143-1049 | 2016-10-11 |
| 1659824175 | Stephanie Lynn Corman | Nurse Practitioner | 679 E County Line Rd, Greenwood, IN 46143-1049 | 2016-08-02 |
| 1548619190 | Alexander John Felt | Physician Assistant | 679 E County Line Rd, Greenwood, IN 46143-1049 | 2016-06-05 |
| 1225485899 | Urology of Indiana, LLC | Obstetrics & Gynecology | 679 E County Line Rd, Greenwood, IN 46143-1049 | 2016-05-24 |
| 1073969457 | Maria Huynh | Nurse Practitioner | 679 E County Line Rd, Greenwood, IN 46143-1049 | 2016-05-04 |
| 1295145159 | Brian Orr | Urology | 679 E County Line Rd, Greenwood, IN 46143-1049 | 2014-04-30 |
| 1376981084 | Teresa A Lain | Nurse Practitioner | 679 E County Line Rd, Greenwood, IN 46143-1049 | 2013-06-05 |
| 1659613818 | Christine Pan | Obstetrics & Gynecology | 679 E County Line Rd, Greenwood, IN 46143-1049 | 2013-03-25 |
| 1033462239 | Jason Ronald Kovac | Urology | 679 E County Line Rd, Greenwood, IN 46143-1049 | 2012-10-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395299 | Tiffany Smirat | Pharmacist | 882 S Sr 135, Greenwood, IN 46143 | 2020-10-27 |
| 1083250138 | Benajmin Thomas Nyboer | Pharmacist | 5961 North State Road 135, Kroger Pharmacy, Greenwood, IN 46143 | 2019-11-25 |
| 1609417260 | Orthopaedics-indianapolis, Inc | Orthopaedic Surgery | 1579 Olive Branch Parke Lane, Suite 130, Greenwood, IN 46143 | 2019-10-04 |
| 1194282525 | Homebased Mental Health Service | Case Management | 2244 Blossom Dr, Greenwood, IN 46143 | 2019-02-21 |
| 1710478078 | Anne E Packard | Pharmacist | 333 E County Line Rd # 101, Greenwood, IN 46143 | 2018-05-22 |
| 1033607924 | Ez Clinic Inc. | Nurse Practitioner | 494 S Emerson Ave Ste I, Greenwood, IN 46143 | 2018-04-25 |
| 1891246633 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 5961 N Sr 135, Greenwood, IN 46143 | 2016-10-17 |
| 1477919637 | Ourhealth Physicians Group, LLC | Clinic/Center | 1273 N Emerson Ave Ste H, Greenwood, IN 46143 | 2016-01-04 |
| 1003212655 | American Health Network of Indiana, LLC | Non-Pharmacy Dispensing Site | 2355 Endress Place St A, Healthy Measures Wellness Clinic, Greenwood, IN 46143 | 2014-11-10 |
| 1265831366 | Katie D'agosto | Counselor | 3000 S State Road 135 Ste 230, Greenwood, IN 46143 | 2014-08-14 |
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| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255930657 | Caitlyn Shuck | Nurse Practitioner | 2641 Marsh Hawk Dr, Greenwood, IN 46143-5749 | 2020-10-19 |
| 1275015984 | Monyce Evans | Nurse Practitioner | 6474 Old School Ln, Greenwood, FL 32443-2018 | 2018-08-30 |
| 1225447923 | Lisa Terrell | Nurse Practitioner | 902 Sgt. John Pittman Drive, Greenwood, MS 38930-2800 | 2014-08-06 |
| 1588969448 | Self Medical Group | Nurse Practitioner | 104 Liner Drive, Greenwood, SC 29646 | 2011-01-24 |
| 1770742462 | Stacy Wade | Nurse Practitioner | 1260 Innovation Pkwy Ste 100, Greenwood, IN 46143 | 2008-06-06 |
| 1326095738 | Sandra Cameron | Nurse Practitioner | 2696 Main Street, Greenwood, NY 14839-0784 | 2006-05-30 |
| 1306458237 | Rosanna Walker | Nurse Practitioner | 408 W Alexander Ave, Greenwood, SC 29646-4031 | 2020-08-21 |
| 1992346076 | Adraine Marie Cox | Nurse Practitioner | 102 Professional Pl, Greenwood, MS 38930-9633 | 2019-09-30 |
| 1013477587 | Laura Walradth | Nurse Practitioner | 1703 W Stones Crossing Rd Ste 200, Greenwood, IN 46143-8558 | 2019-03-21 |
| 1902362734 | Tammie Marshell Brown | Nurse Practitioner | 1401 River Rd, Greenwood, MS 38930-4030 | 2019-02-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.