Individual provider Active NPI

Crystal Shuandale Killian, NP

  • Adult Health Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1114493111
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5011122 Issued in NC
Practice address
1875 Remount Rd
Gastonia, NC 28054-7413
Phone
(704) 874-0600
NPI assigned
Oct 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5011122 NC
Primary Care Nurse Practitioner 363LP2300X 5011122 NC
Adult Health Nurse Practitioner 363LA2200X 5011122 NC Primary
Gerontology Nurse Practitioner 363LG0600X 5011122 NC

Addresses

Primary practice location

1875 Remount Rd
Gastonia, NC 28054-7413

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 730-7003

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ckillian@carolinacaring.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190903002577 NC Practitioner - Nurse Practitioner 5890032254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Duke University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3975 Robinson Rd
Newton, NC 28658-9715

Hospital & facility affiliations

  • Caromont Regional Medical Center Hospital, Gastonia, NC, CCN 340032

Merit-based Incentive Payment System (MIPS)

Final score
89.72 of 100Reported as apm
Quality
72.97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5011122NCMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adult and Geriatric Healthcare PLLC Adult Health Current Accepting new patients
Carolina Caring Serious Illness, LLC CurrentSince Nov 4, 2024 Accepting new patients
CS Pacs 3 Southeast, LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

707 N Elm St
High Point, NC 27262
Phone (336) 885-0141

204 E Old Highway 74
Monroe, NC 28112
Phone (704) 283-3066

3975 Robinson Rd
Newton, NC 28658
Phone (828) 466-0466

515 Barbour Rd
Smithfield, NC 27577
Phone (919) 227-6261

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1114493111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-730-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 REMOUNT RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547413",
            "telephone_number": "704-874-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLIAN",
        "first_name": "CRYSTAL",
        "middle_name": "SHUANDALE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011122",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5011122",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5011122",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5011122",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckillian@carolinacaring.org",
            "affiliation": "N",
            "address_1": "3975 Robinson Rd",
            "city": "Newton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286589715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.