Individual provider Active NPI

Alexis Michelle Chrystal, PHARMD

  • Pharmacist
  • Lake Milton, OH
National Provider Identifier
1639720170
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03439116 Issued in OH
Practice address
17674 Mahoning Ave
Lake Milton, OH 44429-9582
Phone
(330) 654-3792
NPI assigned
Sep 25, 2019
Last updated
Mar 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03439116 OH Primary

Addresses

Primary practice location

17674 Mahoning Ave
Lake Milton, OH 44429-9582

Mailing address

7006 Fairview Rd
Austintown, OH 44515-4317

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
03439116OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wexco LTD Pharmacist Current Accepting new patients
Rite Aid of Ohio Inc PastSince Sep 1, 2019 Accepting new patients

Locations

17674 Mahoning Ave
Lake Milton, OH 44429
Phone (330) 654-3339

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1639720170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7006 FAIRVIEW RD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445154317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17674 MAHONING AVE",
            "city": "LAKE MILTON",
            "state": "OH",
            "postal_code": "444299582",
            "telephone_number": "330-654-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRYSTAL",
        "first_name": "ALEXIS",
        "middle_name": "MICHELLE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03439116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Milton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.