Individual provider Active NPI

Crystal Hickman, D.C.

  • Chiropractor
  • Atlanta, GA
National Provider Identifier
1417637836
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010865 Issued in GA
Practice address
5555 Glenridge Connector Ste 200
Atlanta, GA 30342-4815
Phone
(336) 306-6937
NPI assigned
Jul 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR010865 GA Primary

Addresses

Primary practice location

5555 Glenridge Connector Ste 200
Atlanta, GA 30342-4815

Mailing address

5555 Glenridge Connector Ste 200
Atlanta, GA 30342-4815
Phone (336) 306-6937

Other names 1

  • Dr. Crystal James Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230921004317 GA Practitioner - Chiropractic 0345694592 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life University, Inc Chiropractor CurrentSince Aug 9, 2023 Accepting new patients
Life University Inc Chiropractor CurrentSince Aug 9, 2023 Accepting new patients
Life University, Inc Chiropractor Current Accepting new patients

Locations

1323 Roswell Rd
Marietta, GA 30062
Phone (770) 426-2946

1323 Roswell Rd
#300
Marietta, GA 30062
Phone (770) 426-2786

1415 Barclay Cir SE
Marietta, GA 30060
Phone (770) 426-2786

Interoperability endpoints

  • Direct secure messaging: crystal.hickman.p2@direct.life.nextgenshare.com
  • Direct secure messaging: crystal.hickman.p1@direct.life.nextgenshare.com

Organizations & group practices 3

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": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1417637836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 GLENRIDGE CONNECTOR STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424815",
            "telephone_number": "336-306-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GLENRIDGE CONNECTOR STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424815",
            "telephone_number": "336-306-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "CRYSTAL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-20",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "JAMES",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.