Individual provider Active NPI

Crystal E Nolan, FNP RNFA

  • Family Nurse Practitioner
  • Glens Falls, NY
National Provider Identifier
1194166165
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
338169 Issued in NY
Practice address
90 South St
Glens Falls, NY 12801-4328
Phone
(518) 792-7841
Fax
(518) 932-0289
NPI assigned
Jul 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 338169 NY Primary

Addresses

Primary practice location

90 South St
Glens Falls, NY 12801-4328

Mailing address

9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300

Other practice location 1

111 N Orange Ave Ste 800
Orlando, FL 32801-2381
Phone (888) 731-8994

Other practice location 2

139 Centre St Ph 120
New York, NY 10013-4559
Phone (888) 731-8994

Other practice location 3

161 Carey Rd
Queensbury, NY 12804-7821
Phone (518) 824-8610

Other identifiers 1

IdentifierTypeStateIssuer
03688126MedicaidNY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address crystal.nolan.1@1823.direct.athenahealth.com
Direct Messaging Address crystal.nolan.1@1823.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140321000063 NY Practitioner - Nurse Practitioner 7012148778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Headwaters Health NetworkGroup PAC ID 7416861208, 221 clinicians

Practice addresses (Care Compare)

100 Park St
Glens Falls, NY 12801-4413
Phone (518) 926-1000

161 Carey Rd
Queensbury, NY 12804-7821
Phone (518) 824-8610

24 Fairfield Ave
Schroon Lake, NY 12870-0292
Phone (518) 532-7120

Hospital & facility affiliations

  • Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
338169NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Headwaters Health Network CurrentSince Oct 31, 2016 Accepting new patients
Hudson Headwaters Health Network CurrentSince Oct 31, 2016 Accepting new patients
Hudson Headwaters Health Network Past Accepting new patients

Locations

90 South St
Glens Falls, NY 12801
Phone (518) 792-1233

161 Carey Rd
Queensbury, NY 12804
Phone (518) 480-0011

9 Carey Rd
Queensbury, NY 12804

Interoperability endpoints

  • Direct secure messaging: crystal.nolan.1@27069.direct.athenahealth.com

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": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1194166165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047880",
            "telephone_number": "518-761-0300",
            "fax_number": "518-824-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 SOUTH ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014328",
            "telephone_number": "518-792-7841",
            "fax_number": "518-932-0289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 N Orange Ave Ste 800",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328012381",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "139 Centre St Ph 120",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100134559",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "161 Carey Rd",
            "address_purpose": "LOCATION",
            "city": "Queensbury",
            "state": "NY",
            "postal_code": "128047821",
            "country_code": "US",
            "telephone_number": "518-824-8610",
            "fax_number": "518-824-2390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "CRYSTAL",
        "middle_name": "E",
        "credential": "FNP RNFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "338169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03688126",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crystal.nolan.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "90 South St",
            "city": "Glens Falls",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128014328",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crystal.nolan.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "161 Carey Rd",
            "city": "Queensbury",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128047821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

Verify at the official NPI Registry.