Individual provider Active NPI

Crystal Young Kaplan, ARNP

  • Acute Care Nurse Practitioner
  • Henderson, NC
National Provider Identifier
1124584206
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
5017007 Issued in NC
Practice address
566 Ruin Creek Rd
Henderson, NC 27536-2927
Phone
(252) 436-1148
NPI assigned
Feb 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 9492728 FL
Acute Care Nurse Practitioner 363LA2100X 5017007 NC Primary

Addresses

Primary practice location

566 Ruin Creek Rd
Henderson, NC 27536-2927

Mailing address

566 Ruin Creek Rd
Henderson, NC 27536-2927
Phone (252) 436-1148

Other practice location 1

22395 Edgewater Dr
Port Charlotte, FL 33980
Phone (941) 766-7222

Other practice location 2

22395 Edgewater Dr
Port Charlotte, FL 33980
Phone (941) 766-7222

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
I20221116000381 NC Practitioner - Nurse Practitioner 1153653134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DLP Maria Parham Physician Practices LLCGroup PAC ID 7719153683, 54 clinicians

Practice addresses (Care Compare)

566 Ruin Creek Rd
Henderson, NC 27536-2927
Phone (252) 436-1148

Hospital & facility affiliations

  • Maria Parham Medical Center Hospital, Henderson, NC, CCN 340132
  • Granville Health Systems Hospital, Oxford, NC, CCN 340127

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9492728FLMDAcute Care Nurse Practitioner
5017007NCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Maria Parham Physician Practices, LLC Current Accepting new patients
DLP Maria Parham Physician Practices, LLC CurrentSince Jan 1, 2023 Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Jan 1, 2023 Accepting new patients
DLP Maria Parham Physician Practices, LLC Past Accepting new patients

Locations

566 Ruin Creek Rd
Henderson, NC 27536
Phone (252) 436-1352

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: crystal.kaplan.1@20247.direct.athenahealth.com

Organizations & group practices 4

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 3

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": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1124584206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "566 RUIN CREEK RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362927",
            "telephone_number": "252-436-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "566 RUIN CREEK RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362927",
            "telephone_number": "252-436-1148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22395 Edgewater Dr",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "33980",
            "country_code": "US",
            "telephone_number": "941-766-7222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22395 Edgewater Dr",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "33980",
            "country_code": "US",
            "telephone_number": "941-766-7222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAPLAN",
        "first_name": "CRYSTAL",
        "middle_name": "YOUNG",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-14",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "9492728",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5017007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NC

Sources for this page

Verify at the official NPI Registry.