Individual provider Active NPI

Crystal McCoy Myers, PT

  • Physical Therapist
  • Charlotte, NC
National Provider Identifier
1144541566
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P13427 Issued in NC
Practice address
6314 Autumn Moss CT
Charlotte, NC 28277-3514
Phone
(757) 409-1955
Fax
(980) 236-9399
NPI assigned
Jun 21, 2010
Last updated
Sep 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P13427 NC Primary

Addresses

Primary practice location

6314 Autumn Moss CT
Charlotte, NC 28277-3514

Mailing address

6314 Autumn Moss CT
Charlotte, NC 28277-3514
Phone (757) 409-1955

Other names 1

  • Crystal McCoy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211012000595 NC Practitioner - Physical Therapist in Private Practice 8628476355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meaningful Movement, LLCGroup PAC ID 7719385442, 5 clinicians

Practice addresses (Care Compare)

7401 Carmel Executive Park Dr
Suite 305
Charlotte, NC 28226-4219
Phone (980) 785-3773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P13427NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Meaningful Movement LLC Physical Therapist CurrentSince Sep 27, 2021 Accepting new patients

Locations

7401 Carmel Executive Park Dr
Ste 305
Charlotte, NC 28226
Phone (980) 785-3773

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1144541566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6314 AUTUMN MOSS CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773514",
            "telephone_number": "757-409-1955",
            "fax_number": "980-236-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6314 AUTUMN MOSS CT",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773514",
            "telephone_number": "757-409-1955",
            "fax_number": "980-236-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "CRYSTAL",
        "middle_name": "MCCOY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P13427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "MCCOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.