Crystal Rae Clendennen Peirce, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

677 Church St NE
Marietta, GA 30060-1101

Phone

(209) 573-6181

NPI assigned

Jan 28, 2022

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 Clendennen Peirce Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1134872245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 PORTERFIELD RD",
            "city": "PORTER",
            "state": "ME",
            "postal_code": "040683636",
            "telephone_number": "801-425-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601101",
            "telephone_number": "209-573-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLENDENNEN PEIRCE",
        "first_name": "CRYSTAL",
        "middle_name": "RAE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "PEIRCE",
            "middle_name": "CLENDENNEN",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Roger Cleckley, M.A.
• Clyde Lee Clem IV, PT
• Emily Paris Clements, FNP-C
• Larry Clements, MD
• Tiara Shyrese Clemmons, BCABA
• Cleveland Venture Group
• Stacy Arnett Cleveland, M.S., BCBA
• Treven Cliatt
• Susie Tharpe Click, LPC
• Heather Elaine Cliff, D.C.

• Student in an Organized Health Care Education/Training Program in Marietta, GA
• Providers in Marietta, GA by specialty
• Student in an Organized Health Care Education/Training Program in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.