Individual provider Active NPI

Crystal J Jones, FNP-C

  • Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1457898728
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
001180888 Issued in VA
Practice address
4333 Mooring CT
Chesapeake, VA 23321-1982
Phone
(757) 515-8959
NPI assigned
Jan 25, 2017
Last updated
Oct 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 001180888 VA Primary

Addresses

Primary practice location

4333 Mooring CT
Chesapeake, VA 23321-1982

Mailing address

4333 Mooring CT
Chesapeake, VA 23321-1982
Phone (757) 769-4274

Other identifiers 1

IdentifierTypeStateIssuer
1457898728OtherVANOT APPLICABLE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Suffolk Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20211112000527 VA Practitioner - Nurse Practitioner 3971992942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Gateway Medical and Mental Healthcare LLCGroup PAC ID 3173912144, 2 clinicians

Practice addresses (Care Compare)

1530 Breezeport Way
Suite 100
Suffolk, VA 23435-3753
Phone (757) 394-1135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001180888VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Medical & Mental Healthcare, LLC Nurse Practitioner CurrentSince Jun 22, 2021 Accepting new patients

Locations

1545 Crossways Blvd
Ste 250
Chesapeake, VA 23320
Phone (757) 206-2772

4037 Taylor Rd
Ste C
Chesapeake, VA 23321
Phone (757) 394-1135

1530 Breezeport Way
Ste 100
Suffolk, VA 23435
Phone (757) 394-1135

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

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1457898728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4333 MOORING CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233211982",
            "telephone_number": "757-769-4274",
            "fax_number": "757-394-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4333 MOORING CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233211982",
            "telephone_number": "757-515-8959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "CRYSTAL",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "001180888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOT APPLICABLE",
            "identifier": "1457898728",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Suffolk",
            "affiliation": "N",
            "endpointDescription": "office",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct",
            "address_1": "3897 Bridge Rd.",
            "address_2": "104",
            "city": "Suffolk",
            "state": "VA",
            "country_code": "UM",
            "postal_code": "23435",
            "country_name": "United States Minor Outlying Islands",
            "address_type": "FGN"
        }
    ],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.