Active NPI
Crystal Gunn Simpson, PT
- Physical Therapist
- Bel Air, MD
National Provider Identifier
1073701793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 26951
- Practice address
- 12 Medstar Blvd Ste 325
Bel Air, MD 21015 - Phone
- (410) 877-8078
- Fax
- (410) 877-8079
- NPI assigned
- Oct 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT8071 | GA | |
| Physical Therapist | 225100000X | 26951 | MD | Primary |
Addresses
Primary practice location
12 Medstar Blvd Ste 325
Bel Air, MD 21015
Mailing address
12 Medstar Blvd Ste 325
Bel Air, MD 21015-1817
Phone (410) 877-8078
Other practice location 1
1025-4 East-West Connector SW
Suite 406
Austell, GA 30106-8513
Phone (770) 384-1001
Other names 1
- Crystal Chauntel Gunn
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT8071 | GA | MD | Physical Therapist |
| 26951 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532649600000",
"number": "1073701793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 MEDSTAR BLVD STE 325",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210151817",
"telephone_number": "410-877-8078",
"fax_number": "410-877-8079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 MEDSTAR BLVD STE 325",
"city": "BEL AIR",
"state": "MD",
"postal_code": "21015",
"telephone_number": "410-877-8078",
"fax_number": "410-877-8079"
}
],
"practiceLocations": [
{
"address_1": "1025-4 East-West Connector SW",
"address_2": "Suite 406",
"address_purpose": "LOCATION",
"city": "Austell",
"state": "GA",
"postal_code": "301068513",
"country_code": "US",
"telephone_number": "770-384-1001",
"fax_number": "770-384-0333",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIMPSON",
"first_name": "CRYSTAL",
"middle_name": "GUNN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-09",
"last_updated": "2018-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT8071",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "26951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CRYSTAL",
"last_name": "GUNN",
"middle_name": "CHAUNTEL",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Bel Air, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.