Crystal Miller Proud, M.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

0101258310 Issued in VA

Practice address

850 Southampton Ave
Norfolk, VA 23510-1021

Phone

(757) 668-9920

Fax

(757) 668-9930

NPI assigned

Apr 3, 2009

Last updated

Oct 19, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric MedicineAlso: Neurology

Education

Eastern Virginia Medical School, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Childrens Specialty Group PLLCGroup PAC ID 5890788764, 89 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Childrens Hospital of the Kings Daughters Inc Hospital, Norfolk, VA, CCN 493301

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Childrens Specialty Group PLLC

  • Pediatrics Physician
  • Norfolk, VA
  • NPI 1255354130
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Childrens Hospital of the Kings Daughters Inc

  • Psychiatric Hospital Unit
  • Norfolk, VA
  • NPI 1669137121
  Care Compare affiliation
• Childrens Hospital of the Kings Daughters Inc

  • Children's Hospital
  • Norfolk, VA
  • NPI 1912919481
  Care Compare affiliation

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

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1013159177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 SOUTHAMPTON AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 SOUTHAMPTON AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101021",
            "telephone_number": "757-668-9920",
            "fax_number": "757-668-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUD",
        "first_name": "CRYSTAL",
        "middle_name": "MILLER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-03",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CA",
            "license": "A117087",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "VA",
            "license": "0101258310",
            "primary": true
        },
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "VA",
            "license": "0101258310",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Prom, DPT
• Promising Peace Home Health Care
• Jennifer Proper, OT
• Prosperity Eating Disorder and Wellness (Prosperity/Norfolk)
• Prosperity in-Home Health Care Servicec, LLC (Prosperity in-Home Health Care Services-Hampton Roads)
• Rachael Harris Proumen, DO
• Provider Source Home Health Care
• Province Place
• Provisions Medical Transport, LLC
• Eric Landry Provo

• Neurology with Special Qualifications in Child Neurology Physician in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.