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NPISignal

Individual Healthcare Provider

Crystal Vaughn Manse, M.D.

NPI Record: ActiveInternal Medicine
NPI1366702870
O Fallon, Illinois

Provider's NPPES record last updated: September 12, 2024

Overview

Entity Type
Individual Healthcare Provider
NPI
1366702870
Primary Specialty
Internal Medicine
Practice Location
O Fallon, Illinois
Sole Proprietor
No

Federal Screening

NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.

List of Excluded Individuals/Entities (LEIE)

HHS Office of Inspector General

No potential match identified

No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.

Source data
September 10, 2026
Records indexed
84,001
Screened
Sep 20, 2026, 6:24 AM UTC

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

SAM.gov Exclusions

U.S. General Services Administration

Not checked

SAM.gov Exclusions was not checked.

SAM.gov screening is not configured on this deployment. No SAM check has been performed.

Screened
Not checked

This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.

This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.

Run a name-based screening

Searches OIG LEIE and SAM.gov by name and reviews every potential match.

Specialties & Taxonomies

  • Internal Medicine

    Allopathic & Osteopathic Physicians

    Primary

    A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

    Taxonomy code 207R00000X
  • General Practice

    Allopathic & Osteopathic Physicians

    A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

    Taxonomy code 208D00000X
  • Hospitalist

    Allopathic & Osteopathic Physicians

    Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

    Taxonomy code 208M00000X

Provider-Reported License Information

Internal Medicine (Illinois)
036139867
General Practice (Virginia)
0101255760
Hospitalist (Illinois)
036139867
License numbers are reported by the provider to NPPES and are not independently verified by NPISignal against any state licensing board. Confirm current license status directly with the issuing state board.

Practice Locations

Practice Location

3 Saint Elizabeth Blvd Ste 4000

O Fallon, Illinois 62269-1284

Phone: (618) 233-5480

Additional Practice Location

375th Medical Group

310w Losey St

Scott Afb, Illinois 62225

Phone: (618) 256-7799

Additional Practice Location

2200 Bergquist Dr

Wilford Hall Ambulatory Surgical Center

Lackland a F B, Texas 78236-9907

Phone: (210) 292-7805

Fax: (210) 292-7868

Record Information

Enumeration Date
May 18, 2012
Provider's NPPES Record Last Updated
September 12, 2024
Certification Date
September 12, 2024
NPISignal NPPES Dataset
August 2026

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