Individual provider Active NPI

Crystelle Leeellen Carmack, CRNP

  • Family Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1295031169
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-109160 Issued in AL
Practice address
1 Perimeter Park S Ste 100N
Birmingham, AL 35243-3248
Phone
(866) 849-0692
NPI assigned
Feb 9, 2011
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP032000 PA
Family Nurse Practitioner 363LF0000X 5021315 NC
Family Nurse Practitioner 363LF0000X 27084 SC
Family Nurse Practitioner 363LF0000X 231008 AR
Family Nurse Practitioner 363LF0000X 2024046764 MO
Family Nurse Practitioner 363LF0000X AP4444 AZ
Family Nurse Practitioner 363LF0000X 31680 TN
Family Nurse Practitioner 363LF0000X APRN-5064 HI
Family Nurse Practitioner 363LF0000X 1-109160 AL Primary
Family Nurse Practitioner 363LF0000X SP032000 PA
Family Nurse Practitioner 363LF0000X 71016301A IN
Family Nurse Practitioner 363LF0000X APRN11022060 FL
Family Nurse Practitioner 363LF0000X APRN.CNP.0034762 OH
Family Nurse Practitioner 363LF0000X 907103 MS
Family Nurse Practitioner 363LF0000X 209027339 IL

Addresses

Primary practice location

1 Perimeter Park S Ste 100N
Birmingham, AL 35243-3248

Mailing address

PO Box 211699
Eagan, MN 55121-3699
Phone (866) 849-0692

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dmglicenseupdates@devoted.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, AZ, FL, TN, SC, IL, TX, MS, NC9 enrollments
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 9

Enrollment IDStateProvider typePAC IDDetails
I20110802000386 AL Practitioner - Nurse Practitioner 2668641044 Reassigns benefits to 1 organization
I20120517000399 AZ Practitioner - Nurse Practitioner 2668641044 Reassigns benefits to 1 organization
I20221202000846 FL Practitioner - Nurse Practitioner 2668641044 Reassigns benefits to 1 organization
I20230517002714 TN Practitioner - Nurse Practitioner 2668641044 Reassigns benefits to 1 organization
I20230522002220 SC Practitioner - Nurse Practitioner 2668641044
I20230524002264 IL Practitioner - Nurse Practitioner 2668641044 Reassigns benefits to 1 organization
I20230612000119 TX Practitioner - Nurse Practitioner 2668641044 Reassigns benefits to 1 organization
I20250104000033 MS Practitioner - Nurse Practitioner 2668641044 Reassigns benefits to 1 organization
I20250130000527 NC Practitioner - Nurse Practitioner 2668641044 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP032000PAMDNurse Practitioner
231008ARMDFamily Nurse Practitioner
AP4444AZMDFamily Nurse Practitioner
APRN11022060FLMDFamily Nurse Practitioner
APRN-5064HIMDFamily Nurse Practitioner
71016301AINMDFamily Nurse Practitioner
2024046764MOMDFamily Nurse Practitioner
907103MSMDFamily Nurse Practitioner
5021315NCMDFamily Nurse Practitioner
31680TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Devoted Medical NC PC Single Specialty CurrentSince Dec 23, 2024 Accepting new patients
Devoted Medical PC Single Specialty CurrentSince May 10, 2023 Accepting new patients
Devoted Medical Group of Texas Inc Single Specialty CurrentSince May 10, 2023 Accepting new patients

Locations

200 S Wacker Dr
Fl 31
Chicago, IL 60606
Phone (313) 716-0029

221 Crescent St
Ste 202
Waltham, MA 02453
Phone (617) 958-1611

220 N Main St
Ste 500
Greenville, SC 29601
Phone (347) 294-3414

1201 Fannin St
Ste 262
Houston, TX 77002
Phone (346) 768-8399

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1295031169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PERIMETER PARK S STE 100N",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352433248",
            "telephone_number": "866-849-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMACK",
        "first_name": "CRYSTELLE",
        "middle_name": "LEEELLEN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-09",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP032000",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5021315",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "27084",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "231008",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024046764",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4444",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "31680",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-5064",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-109160",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP032000",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71016301A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11022060",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0034762",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907103",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209027339",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmglicenseupdates@devoted.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "880 SW 145th Ave Ste 202",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330276171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.