Krystal Leigh Berthelette, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1415 Issued in SC

Practice address

5420 Forest Dr
Columbia, SC 29206-5401

Phone

(803) 790-4600

NPI assigned

Aug 20, 2006

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

Other names 1

• Miss Krystal Leigh Joyner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003921180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 LATONEA DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292107572",
            "telephone_number": "803-798-8642",
            "fax_number": "803-798-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 FOREST DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292065401",
            "telephone_number": "803-790-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTHELETTE",
        "first_name": "KRYSTAL",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTAL",
            "last_name": "JOYNER",
            "middle_name": "LEIGH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicole Ashley Berry, FNP
• Richard Scott Berry, PHARMD
• Tyeler Chase Berry, DC
• Walter S Berry
• Sharon Diane Berrycarrion, CRNA
• Katie Elizabeth Bertsch
• Leslie Diane Bessellieu, PH.D.
• Best Sleep Solutions
• Casey Morehouse Best
• Mary Best, RBT

• All providers in Columbia, SC
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.