Crystal Medley Green, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5013900 Issued in NC

Practice address

555 Kitchings Dr
Statesville, NC 28677-3576

Phone

(704) 978-1144

Fax

(704) 978-1148

NPI assigned

Mar 21, 2020

Last updated

Sep 13, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Piedmont Healthcare, P.a.

  • Internal Medicine Physician
  • Statesville, NC
  • NPI 1912999897

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Piedmont Healthcare, PA

  • Durable Medical Equipment & Medical Supplies
  • Statesville, NC
  • NPI 1639041320
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Iredell Memorial Hospital, Incorporated

  • General Acute Care Hospital
  • Statesville, NC
  • NPI 1417944224
  Care Compare affiliation

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

{
    "created_epoch": "1584748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1306472311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 KITCHINGS DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773576",
            "telephone_number": "704-978-1144",
            "fax_number": "704-978-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CRYSTAL",
        "middle_name": "MEDLEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-21",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "HOPK-RD2QQ",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5013900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Landry Schofield Graham, FNP-C
• Brandi Grant, FNP-C
• Lori Greer Gray, RN
• Olga V Gray, FNP
• Aaliyyah Green, LPN
• Elizabeth Green
• Patricia Green, MS,CCC-SLP
• Greenbriar Primary Care, PA
• Elisa Pharr Greene
• Greens at Maple Leaf LLC

• Family Nurse Practitioner in Statesville, NC
• Providers in Statesville, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.