Crystal Venable

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

88505 Issued in NC

Practice address

2171 Ruin Creek Rd
Henderson, NC 27537-8735

Phone

(252) 432-5970

Fax

(252) 572-4489

NPI assigned

Aug 19, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• House of Destiny

  • Mental Illness Community Based Residential Treatment Facility
  • Henderson, NC
  • NPI 1194337006
  NPD Authorized official

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1053923169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W BELLE ST",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275364101",
            "telephone_number": "252-432-5970",
            "fax_number": "252-572-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2171 RUIN CREEK RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275378735",
            "telephone_number": "252-432-5970",
            "fax_number": "252-572-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENABLE",
        "first_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "88505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vance Recovery, PC
• Vance Recovery, PC
• John Robert Vanvenrooy, DMD, MPH, PA
• Shelby H Vanvenrooy, DDS
• Diane Stegall Varnadore, NURSE PRACTITIONER
• Visions of Greatness, Inc
• Deanne Knick Vito, RPH
• Khanh Tuan Vu, M.D.
• Mark Vedder Wainright, D.D.S., M.S.
• Wal-Mart Stores East LP

• Licensed Practical Nurse in Henderson, NC
• Providers in Henderson, NC by specialty
• Licensed Practical Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.