Individual provider Active NPI

Crystal Keith

  • Community Health Registered Nurse
  • Lugoff, SC
National Provider Identifier
1265859417
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
92436 Issued in SC
Practice address
508 Cactus CT
Lugoff, SC 29078-8816
Phone
(803) 484-4180
Fax
(803) 484-4580
NPI assigned
Mar 26, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
92436SCMDCommunity Health Registered Nurse

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 92436 SC Primary

Addresses

NPPES NPI Registry

Primary practice location

508 Cactus CT
Lugoff, SC 29078-8816

Mailing address

508 Cactus CT
Lugoff, SC 29078-8816
Phone (803) 484-4180

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 26, 2014.

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1265859417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 CACTUS CT",
            "city": "LUGOFF",
            "state": "SC",
            "postal_code": "290788816",
            "telephone_number": "803-484-4180",
            "fax_number": "803-484-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 CACTUS CT",
            "city": "LUGOFF",
            "state": "SC",
            "postal_code": "290788816",
            "telephone_number": "803-484-4180",
            "fax_number": "803-484-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "CRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "SC",
            "license": "92436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lugoff, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.