Crystaline Joi Prothro, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN233492 Issued in GA

Practice address

2782 N Cobb Pkwy
Kennesaw, GA 30152-3472

Phone

(866) 389-2727

NPI assigned

Oct 9, 2020

Last updated

Feb 28, 2025By 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

Medicare fee-for-service enrollment

Enrolled in GA, DC, NC, VA, TN5 enrollments

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 5

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Minuteclinic Diagnostic of Virginia LLCGroup PAC ID 6709960891, 142 clinicians

Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Minuteclinic Diagnostic of Tennessee PCGroup PAC ID 2961428990, 82 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Minuteclinic Diagnostic of Tennessee PC

  • Family Nurse Practitioner
  • Nashville, TN
  • NPI 1457323164
  Medicare reassignment Care Compare group NPD
• Minuteclinic Diagnostic of Virginia LLC

  • Family Nurse Practitioner
  • Leesburg, VA
  • NPI 1417076829

  DC

  Medicare reassignment Care Compare group NPD
• Minuteclinic LLC

  • Family Nurse Practitioner
  • Rockville, MD
  • NPI 1134191836

  GA

  Medicare reassignment Care Compare group
• Realtime Clinics PC

  dba Omega Pediatrics

  • Pediatrics Physician
  • Roswell, GA
  • NPI 1043667934
  NPD (past)

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1568060846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 BRYCE MANOR LN",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300346256",
            "telephone_number": "770-912-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2782 N COBB PKWY",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523472",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1305 Hembree Rd",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300763810",
            "country_code": "US",
            "telephone_number": "470-485-6342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROTHRO",
        "first_name": "CRYSTALINE",
        "middle_name": "JOI",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN233492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Proborowski, BCBA
• Prodigy Health Systems Inc.,
• Progressive Care Associates, Inc.
• Jennifer Cynthia Prospere, LCSW
• Prospine Wellness & Injury Care PC
• Providence Counseling Services LLC
• April Pruitt, RN
• Pruittplace - Kennesaw, LLC
• Psychiatric Healing for All LLC
• PT Solutions of Acworth LLC

• Family Nurse Practitioner in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.