Crystal S Bolanos-Maldonado, MS PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P13978 Issued in NC

Practice address

3910 Goforth Dr
Hope Mills, NC 28348-8529

Phone

(336) 324-8741

NPI assigned

Jan 12, 2016

Last updated

Jan 12, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Crystal S Matthews Former name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Paragon Outpatient Rehabilitation Services, LLC

  dba Synchrony Rehabilitation

  • Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1871867325

  NC, Physical Therapist

  Medicare reassignment NPD
• Paragon Outpatient Rehabilitation Services, LLC

  dba Synchrony Rehab

  • Rehabilitation Clinic/Center
  • Roxboro, NC
  • NPI 1245014380
  NPD
• Rehabcare Group East, LLC

  dba RehabCare

  • Rehabilitation Clinic/Center
  • Asheville, NC
  • NPI 1477507523
  NPD (past)

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1477919017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 GOFORTH DR",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283488529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 GOFORTH DR",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283488529",
            "telephone_number": "336-324-8741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANOS-MALDONADO",
        "first_name": "CRYSTAL",
        "middle_name": "S",
        "credential": "MS PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P13978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC PT LICENSE NUMBER",
            "identifier": "P13978",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "MATTHEWS",
            "middle_name": "S",
            "credential": "MS PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Santanna Bishop
• Blessed Hands Phlebotomy
• Blue Haven Outreach Services
• Destiny Faatima Tiera Blue, MSW, LCSW-A, LCAS-A
• Daniel G Boisse
• Thandiwe Bowling, LCSW-A
• Kathy Ann Boyd, PTA
• Keenyna Brantley
• Lisa Brewer, RRT
• Stephen Thomas Brien, PT, CSCS

• Physical Therapist in Hope Mills, NC
• Providers in Hope Mills, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.