Crystal Dominique Massenburg, AGENCY DIRECTOR

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

HC6520 Issued in NC

Practice address

4819 Emperor Blvd Unit 102
Durham, NC 27703-0089

Phone

(919) 727-0748

NPI assigned

Oct 11, 2022

Last updated

Oct 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Tender Loving Touch Senior Care Services LLC

  • In Home Supportive Care Agency
  • Durham, NC
  • NPI 1053036160
  NPD Authorized official
• Wake Transit

  • Non-emergency Medical Transport (VAN)
  • Raleigh, NC
  • NPI 1487549358
  NPD Authorized official

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1568187664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4819 EMPEROR BLVD UNIT 102",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277030089",
            "telephone_number": "919-727-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4819 EMPEROR BLVD UNIT 102",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277030089",
            "telephone_number": "919-727-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSENBURG",
        "first_name": "CRYSTAL",
        "middle_name": "DOMINIQUE",
        "credential": "AGENCY DIRECTOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "HC6520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crystal@ahe-dur.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "csv",
            "address_1": "4819 Emperor Blvd Unit 102",
            "city": "Durham",
            "state": "NC",
            "country_code": "US",
            "postal_code": "277030089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah E Mason, LCSW
• Aman Masoomi, DDS
• Sabran Jameel Masoud
• Massage Essenz, LLC
• Althea H Massenburg, MD
• Ashley Marie Massengale, AGNP-C
• Meghan Massengill, OT/L
• Edward W Massey, M.D.
• Janice M. Massey, M.D.
• Kristen Fontela Massey

• In Home Supportive Care Agency in Durham, NC
• Providers in Durham, NC by specialty
• In Home Supportive Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.