Crystal A Dockery, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO2736 Issued in ME

Practice address

242 Brunswick St
Old Town, ME 04468-1613

Phone

(207) 827-6128

Fax

(207) 827-6605

NPI assigned

Apr 18, 2014

Last updated

Jul 26, 2021By 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 1

Addresses

Other names 1

• Crystal A Stone Former name

Medicare fee-for-service enrollment

Enrolled in ME2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Joseph HospitalGroup PAC ID 6406766336, 197 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Bangor, ME, CCN 207045
• St Joseph Hospital Hospital, Bangor, ME, CCN 200001
• Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cdockery2758745@direct.bsmhealth.org

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.

• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Medicare reassignment Care Compare group NPD
• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Medicare reassignment

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

• Centerwell Certified Healthcare Corp.

  dba CenterWell Home Health

  • Home Health Agency
  • Bangor, ME
  • NPI 1982638771
  Care Compare affiliation
• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Care Compare affiliation
• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Care Compare affiliation

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1114347069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-404-8200",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 BRUNSWICK ST",
            "city": "OLD TOWN",
            "state": "ME",
            "postal_code": "044681613",
            "telephone_number": "207-827-6128",
            "fax_number": "207-827-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCKERY",
        "first_name": "CRYSTAL",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "DO2736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "STONE",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karen Laflamme Davis, MS CCC-SLP
• Michaela Davis
• Kyle Deliberty, DPT, ATC
• Jerome Alan Dennis
• Ashleigh Gail Deschenes
• Jolene R Driver, PAC
• Amanda Dubois, PHARMACIST
• Jessica Dubois, COTA/L
• Kaitlyn Dunham, PHARMD
• Alexandria Durland, PHARMD, BSHS

• Family Medicine Physician in Old Town, ME
• Providers in Old Town, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.