Crystalle Johnson, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

MW010839 Issued in PA

Practice address

1098 W Baltimore Pike
Suite 3106 RHC 3
Media, PA 19063-5139

Phone

(610) 891-6240

NPI assigned

Nov 21, 2024

Sex

Female

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 PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

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 and National Provider Directory roles.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD
• Main Line Healthcare

  • Urgent Care Clinic/Center
  • Wynnewood, PA
  • NPI 1295214492
  NPD (past)

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

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1003631334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-337-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 W BALTIMORE PIKE",
            "address_2": "SUITE 3106 RHC 3",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635139",
            "telephone_number": "610-891-6240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1068 W Baltimore Pike # 3106",
            "address_purpose": "LOCATION",
            "city": "Media",
            "state": "PA",
            "postal_code": "190635104",
            "country_code": "US",
            "telephone_number": "610-891-6240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CRYSTALLE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-21",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW010839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jih Counseling Inc
• Jmoore Counseling Services
• Jmoore Counseling Services, LLC
• Emily Johansen, PSYD
• John L Brendler, Inc
• Jaime Johnson, PA-C
• Jermaine Marcell Johnson, MS, ABA, MBA
• Jerome Maurice Johnson, MS, ABA, MBA
• Kerry Johnson
• Mark Donald Johnston, PT

• Advanced Practice Midwife in Media, PA
• Providers in Media, PA by specialty
• Advanced Practice Midwife in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.