Individual provider Active NPI

Crystal Lynne Walls, CRNP

  • Family Nurse Practitioner
  • Cumberland, MD
National Provider Identifier
1396222998
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R156273 Issued in MD
Practice address
Western Maryland Health System
12500 Willowbrook Rd
Cumberland, MD 21502
Phone
(240) 964-7000
NPI assigned
Jul 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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 R156273 MD Primary

Addresses

Primary practice location

Western Maryland Health System
12500 Willowbrook Rd
Cumberland, MD 21502

Mailing address

15 S Centre St
Cumberland, MD 21502-3017
Phone (403) 627-2792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20180912003682 MD Practitioner - Nurse Practitioner 9931459922 Reassigns benefits to 2 organizations
I20201013002173 DC Practitioner - Nurse Practitioner 9931459922

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Med 1St Walkin Clinic and Primary CareGroup PAC ID 0345625307, 2 clinicians

Practice addresses (Care Compare)

15 S Centre St
Cumberland, MD 21502-3017
Phone (240) 362-7279

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Med 1St Walkin Clinic and Primary Care CurrentSince Feb 10, 2022 Accepting new patients
Med 1St Walkin Clinic and Primary Care Current Accepting new patients
Upmc Western Maryland Corporation CurrentSince Sep 4, 2018 Accepting new patients
Upmc Western Maryland Corporation Current Accepting new patients
Upmc Western Maryland Health Services, LLC Past Accepting new patients

Locations

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

10701 New Georges Creek Rd SW
Frostburg, MD 21532
Phone (301) 689-2941

23789 Garrett Hwy
Mc Henry, MD 21541
Phone (240) 488-4139

45 Hunt Club Dr
Ridgeley, WV 26753
Phone (304) 726-4501

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1396222998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S CENTRE ST",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215023017",
            "telephone_number": "403-627-2792",
            "fax_number": "240-362-7096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WESTERN MARYLAND HEALTH SYSTEM",
            "address_2": "12500 WILLOWBROOK RD",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "21502",
            "telephone_number": "240-964-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "CRYSTAL",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R156273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

Verify at the official NPI Registry.