Individual provider Active NPI

Crystal L Carter, R.N.

  • Registered Nurse
  • Clarksville, TN
National Provider Identifier
1548419989
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1108054 Issued in KY
Practice address
330 Pageant LN
Clarksville, TN 37040-3854
Phone
(931) 648-5747
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1108054 KY Primary

Addresses

Primary practice location

330 Pageant LN
Clarksville, TN 37040-3854

Mailing address

330 Pageant LN
P. O. Box 1026
Clarksville, TN 37040-3854
Phone (931) 648-5747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1108054KYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1548419989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 PAGEANT LN",
            "address_2": "P. O. BOX 1026",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403854",
            "telephone_number": "931-648-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 PAGEANT LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403854",
            "telephone_number": "931-648-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "CRYSTAL",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1108054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.