Individual provider Active NPI

Crystal Gunn Simpson, PT

  • Physical Therapist
  • Bel Air, MD
National Provider Identifier
1073701793
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26951 Issued in MD
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

Updated by the provider on Jul 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

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

LicenseStateTypeSpecialty
PT8071GAMDPhysical Therapist
26951MDMDPhysical 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.

Verify at the official NPI Registry.