Individual provider Active NPI

Cynthia Crist, MSN, FNP, APRN-BC

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1366657603
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13299 Issued in CA
Practice address
4033 3Rd Ave
Suite 300
San Diego, CA 92103-2117
Phone
(619) 299-2570
Fax
(619) 299-1834
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 13299 CA Primary

Addresses

Primary practice location

4033 3Rd Ave
Suite 300
San Diego, CA 92103-2117

Mailing address

13833 Deanly Way
Lakeside, CA 92040-4849
Phone (619) 443-6599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231113002530 CA Order and Referring Only - Nurse Practitioner 6709902869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13299CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation PastSince Jan 14, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366657603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13833 DEANLY WAY",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920404849",
            "telephone_number": "619-443-6599",
            "fax_number": "619-443-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 3RD AVE",
            "address_2": "SUITE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032117",
            "telephone_number": "619-299-2570",
            "fax_number": "619-299-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIST",
        "first_name": "CYNTHIA",
        "credential": "MSN, FNP, APRN-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "13299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.