Active NPI
Crystal D. Terry, MD
- Anesthesiology Physician
- Alameda, CA
National Provider Identifier
1609914712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G56047
- Practice address
- 2070 Clinton Ave
Alameda, CA 94501-4320 - Phone
- (510) 910-1081
- Fax
- (510) 814-4090
- NPI assigned
- Feb 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G56047 | CA | Primary |
Addresses
Primary practice location
2070 Clinton Ave
Alameda, CA 94501-4320
Mailing address
2070 Clinton Ave
Alameda, CA 94501-4320
Phone (510) 910-1081
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G56047 | CA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404259200000",
"number": "1609914712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2070 CLINTON AVE",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945014320",
"telephone_number": "510-910-1081",
"fax_number": "510-814-4090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2070 CLINTON AVE",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945014320",
"telephone_number": "510-910-1081",
"fax_number": "510-814-4090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERRY",
"first_name": "CRYSTAL",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-01",
"last_updated": "2014-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G56047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alameda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.