NPIMap

Organization Active NPI

Crystal Health Care Services, Inc

  • Nursing Care Agency
  • Charlotte, NC
National Provider Identifier
1376637033
Registry record updated Aug 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
HC3464 Issued in NC
Legal business name
CRYSTAL HEALTH CARE SERVICES, INC
Practice address
1300 Baxter Street
Suite 190
Charlotte, NC 28204-3804
Phone
(704) 334-2311
Fax
(704) 334-2310
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2009

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

Authorized official

Name
Ms. Kathryn T White
Title
President, Administrator
Phone
(704) 334-2311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X HC3464 NC Primary

Addresses

Primary practice location

1300 Baxter Street
Suite 190
Charlotte, NC 28204-3804

Mailing address

1300 Baxter Street
Suite 190
Charlotte, NC 28204-3804
Phone (704) 334-2311

Other identifiers 1

IdentifierTypeStateIssuer
7100589MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Crystal Health Care Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249430400000",
    "number": "1376637033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 BAXTER STREET",
            "address_2": "SUITE 190",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043804",
            "telephone_number": "704-334-2311",
            "fax_number": "704-334-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BAXTER STREET",
            "address_2": "SUITE 190",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043804",
            "telephone_number": "704-334-2311",
            "fax_number": "704-334-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL HEALTH CARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-08-05",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT, ADMINISTRATOR",
        "authorized_official_telephone_number": "704-334-2311",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NC",
            "license": "HC3464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100589",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; 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.