Active NPI
Crystal R Chaffin, MBA, ATP
- Other Technician
- Corpus Christi, TX
National Provider Identifier
1164181889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- ATP91146
- Practice address
- 4410 Dillon LN Ste 17
Corpus Christi, TX 78415-5335 - Phone
- (361) 808-7382
- Fax
- (361) 808-7367
- NPI assigned
- Dec 9, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistive Technology Supplier Rehabilitation Counselor | 225CA2500X | ATP91146 | ||
| Other Technician | 247200000X | ATP91146 | Primary |
Addresses
Primary practice location
4410 Dillon LN Ste 17
Corpus Christi, TX 78415-5335
Mailing address
4410 Dillon LN Ste 17
Corpus Christi, TX 78415-5335
Phone (361) 808-7382
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ATP91146 | Other | ATP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Business Administration
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Russell Medical Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Corpus Christi, TX
- NPI 1578517488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639008000000",
"number": "1164181889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4410 DILLON LN STE 17",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784155335",
"telephone_number": "361-808-7382",
"fax_number": "361-808-7367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4410 DILLON LN STE 17",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784155335",
"telephone_number": "361-808-7382",
"fax_number": "361-808-7367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAFFIN",
"first_name": "CRYSTAL",
"middle_name": "R",
"credential": "MBA, ATP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-09",
"last_updated": "2021-12-09",
"certification_date": "2021-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225CA2500X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor, Assistive Technology Supplier",
"state": null,
"license": "ATP91146",
"primary": false
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": "ATP91146",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATP",
"identifier": "ATP91146",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Corpus Christi, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.