KATIE RAE CRAWFORD (PA-C) – Medical Physician Assistant, NPI 1073159133

KATIE RAE CRAWFORD (PA-C) is a healthcare provider. based in Dardanelle, Arkansas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PT2019-051 (AR). The NPI Number for KATIE RAE CRAWFORD (PA-C) is 1073159133

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
KATIE RAE CRAWFORD (PA-C)
NPI
1073159133
Phone
(479) 229-3004
Address
1176 STATE HIGHWAY 22 W STE B
Enumeration Date
25 November 2019
Last Update Date
3 February 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8709947301
Graduation Year
2019 (7 years ago)
PAC ID
1658704200
Group Practice PAC ID
4789715285
Professional Enrollment ID
I20191212000499
Address ID
AR725139594AS49XXX412X400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

627 PHYSICIAN ASSISTANT in AR

Provider Addresses for KATIE RAE CRAWFORD (PA-C)

  • 1176 STATE HIGHWAY 22 W STE B

    DARDANELLE, AR 728343006

    Phone: (479) 229-3004

    Fax: (870) 994-7488

    Type: Location

  • 101 W MAIN ST

    HARDY, AR 725429566

    Phone:

    Fax: (870) 856-2133

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-12-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20191212000499IPhysician AssistantARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72834)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789715285View full group profile
NameSpecialtyState
Nurse PractitionerAR
Nurse PractitionerAR
-AR
Nurse PractitionerMO
Nurse PractitionerAR
Nurse PractitionerAR
Nurse PractitionerAR
Nurse PractitionerAR
-AR
Nurse PractitionerAR

Reviews

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Frequently asked questions

How do payers reference KATIE RAE CRAWFORD (PA-C)?
For KATIE RAE CRAWFORD (PA-C), use NPI 1073159133 as the unique 10-digit identifier.
Would KATIE RAE CRAWFORD (PA-C) appear as active to a payer?
You can treat KATIE RAE CRAWFORD (PA-C) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with KATIE RAE CRAWFORD (PA-C)?
KATIE RAE CRAWFORD (PA-C)'s record emphasizes Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is KATIE RAE CRAWFORD (PA-C) located near Dardanelle?
KATIE RAE CRAWFORD (PA-C) currently maps to Dardanelle, Arkansas in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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