Individual provider Active NPI

Crystal Lynn Chastain, CNP

  • Gerontology Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1245612654
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN198451 Issued in GA
Practice address
1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone
(678) 312-2418
Fax
(678) 312-2434
NPI assigned
Jun 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X RN198451 GA
Family Nurse Practitioner 363LF0000X RN198451 GA
Gerontology Nurse Practitioner 363LG0600X RN198451 GA Primary

Addresses

Primary practice location

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694

Mailing address

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-2418

Other names 1

  • Crystal Lynn Dale Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address crystal.dale.p2@direct.gmg.nextgenshare.com Direct
Direct Messaging Address crystal.dale.p2@direct.gmg.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20151221000625 GA Practitioner - Nurse Practitioner 9133420987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gwinnett Physician Group, LLCGroup PAC ID 9133211139, 112 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-4321

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.46 of 100Reported as group
Quality
85.33
Promoting interoperability
100
Improvement activities
40
Cost
76.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN198451GAMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Heart Center Current Accepting new patients
Gwinnett Physician Group, LLC CurrentSince Jun 1, 2016 Accepting new patients

Locations

200 S Enota Dr NE
Ste 200
Gainesville, GA 30501
Phone (770) 534-0991

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

100 Medical Center Blvd
#165
Lawrenceville, GA 30046
Phone (678) 312-2600

Organizations & group practices 2

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": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1245612654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467694",
            "telephone_number": "678-312-2418",
            "fax_number": "678-312-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467694",
            "telephone_number": "678-312-2418",
            "fax_number": "678-312-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASTAIN",
        "first_name": "CRYSTAL",
        "middle_name": "LYNN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "GA",
            "license": "RN198451",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN198451",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN198451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crystal.dale.p2@direct.gmg.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct edge",
            "address_1": "743 Spring St NE",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crystal.dale.p2@direct.gmg.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "743 Spring St NE",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "DALE",
            "middle_name": "LYNN",
            "credential": "CNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.