Individual provider Active NPI

Crystal Corica, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Weston, WV
National Provider Identifier
1558958405
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
107707 Issued in WV
Practice address
936 Sharpe Hospital Rd
Weston, WV 26452-8550
Phone
(304) 269-1210
NPI assigned
Dec 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 107707 WV Primary

Addresses

Primary practice location

936 Sharpe Hospital Rd
Weston, WV 26452-8550

Mailing address

936 Sharpe Hospital Rd
Weston, WV 26452-8550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20210208000177 WV Practitioner - Nurse Practitioner 6204240062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William R Sharpe Jr HospitalGroup PAC ID 8224949383, 19 clinicians

Practice addresses (Care Compare)

936 Sharpe Hospital Rd
Weston, WV 26452-8550
Phone (304) 269-1210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
William R Sharpe Jr Hospital CurrentSince Jan 13, 2021 Accepting new patients
William R. Sharpe, Jr. Hospital CurrentSince Jan 13, 2021 Accepting new patients

Locations

936 Sharpe Hospital Rd
Weston, WV 26452
Phone (304) 269-1210

Organizations & group practices 2

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": "1609027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1558958405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 SHARPE HOSPITAL RD",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264528550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 SHARPE HOSPITAL RD",
            "city": "WESTON",
            "state": "WV",
            "postal_code": "264528550",
            "telephone_number": "304-269-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORICA",
        "first_name": "CRYSTAL",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-27",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WV",
            "license": "107707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WV

Sources for this page

Verify at the official NPI Registry.