Active NPI
Chrystle Medina
- Behavior Analyst
- Salisbury, MD
National Provider Identifier
1255817235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-18-29595
- Practice address
- 100 N Division St Ste 2a
Salisbury, MD 21801-5039 - Phone
- (661) 478-9586
- NPI assigned
- Jul 13, 2018
- Last updated
- Jan 25, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-18-29595 | Primary |
Addresses
Primary practice location
100 N Division St Ste 2a
Salisbury, MD 21801-5039
Mailing address
2636 N Salisbury Blvd # 1032
Salisbury, MD 21801-2141
Other practice location 1
340 E Avenue I
Lancaster, CA 93535-1900
Phone (714) 673-9382
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joyful Behavior Analytic Services | Behavior Analyst | Current | Accepting new patients |
Locations
2636 N Salisbury Blvd
Salisbury, MD 21801
Phone (206) 471-0110
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.
-
- Behavior Analyst
- Salisbury, MD
- NPI 1164179206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674604800000",
"number": "1255817235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2636 N SALISBURY BLVD # 1032",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218012141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N DIVISION ST STE 2A",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218015039",
"telephone_number": "661-478-9586"
}
],
"practiceLocations": [
{
"address_1": "340 E Avenue I",
"address_purpose": "LOCATION",
"city": "Lancaster",
"state": "CA",
"postal_code": "935351900",
"country_code": "US",
"telephone_number": "714-673-9382",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEDINA",
"first_name": "CHRYSTLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-13",
"last_updated": "2023-01-25",
"certification_date": "2022-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-18-29595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.