Individual provider Active NPI

Crysta Devine, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1457009169
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3017544 Issued in KY
Practice address
104 Daventry LN
Louisville, KY 40223-2883
Phone
(502) 200-7043
NPI assigned
Mar 11, 2022
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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 3017544 KY Primary

Addresses

Primary practice location

104 Daventry LN
Louisville, KY 40223-2883

Mailing address

104 Daventry Lane
Louisville, KY 40223
Phone (502) 200-7043

Other identifiers 1

IdentifierTypeStateIssuer
3017544OtherKYAPRN LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20220407002644 KY Practitioner - Nurse Practitioner 2365838984 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simplicity Health Nursing HomeGroup PAC ID 2668822891, 10 clinicians

Practice addresses (Care Compare)

104 Daventry LN
Suite 2
Louisville, KY 40223-2883
Phone (502) 445-7957

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
21.66 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
72.21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP CurrentSince Apr 9, 2025 Accepting new patients
Simplicity Health Nursing Home CurrentSince Feb 1, 2025 Accepting new patients
Simplicity Transitional Health LLC CurrentSince Feb 1, 2025 Accepting new patients

Locations

104 Daventry Ln
Ste 2
Louisville, KY 40223
Phone (502) 445-7957

446 Mount Holly Ave
Louisville, KY 40206
Phone (502) 897-1646

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (317) 701-2379

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1457009169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 DAVENTRY LANE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40223",
            "telephone_number": "502-200-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 DAVENTRY LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232883",
            "telephone_number": "502-200-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVINE",
        "first_name": "CRYSTA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-11",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3017544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE NUMBER",
            "identifier": "3017544",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.