Crystal City Nursing Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH2655 Issued in VA

Legal business name

CRYSTAL CITY NURSING CENTER, INC.

Doing business as

Potomac Center

Practice address

1785 S Hayes St
Arlington, VA 22202-2714

Phone

(703) 920-5700

Fax

(703) 979-8190

NPI assigned

Jun 17, 2006

Organization subpart

No

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

Authorized official

Name

Jane Dropeskey

Title

Corporate Manager

Phone

(610) 925-4231

Specialties & licenses 1

Addresses

Other identifiers 10

Other names 1

• Potomac Center Doing business as

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1104861038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-925-4436",
            "fax_number": "610-925-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 S HAYES ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222022714",
            "telephone_number": "703-920-5700",
            "fax_number": "703-979-8190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL CITY NURSING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "DROPESKEY",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "CORPORATE MANAGER",
        "authorized_official_telephone_number": "610-925-4231"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030909900",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST-PROV/INQ#",
            "identifier": "02PV",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED - MAMSI",
            "identifier": "241381",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST - IND/PPO",
            "identifier": "H18",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "47579",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECHOICE",
            "identifier": "H18",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "147180",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED - AMERICHOICE",
            "identifier": "7100077",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004951140",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA-HMO",
            "identifier": "0082366",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potomac Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tabitha Fay Croy, LMT
• Monica Crum, RN, IBCLC
• Evelyn Alexandra Cruz Herbas, DDS
• Crystal City Chiropractic
• Crystal City Dental Arts Center
• Crystal Eye Care,Inc
• Crystal Smile, PLLC
• Gerson J Cuellar, D.D.S.
• Ruben Dario Cuellar, DDS
• Mercedes V Cueva

• Skilled Nursing Facility in Arlington, VA
• Providers in Arlington, VA by specialty
• Skilled Nursing Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.