Chrystal Shirley, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11012141 Issued in FL

Practice address

215 N 3Rd St
Leesburg, FL 34748-5105

Phone

(352) 315-7900

NPI assigned

Apr 13, 2021

Last updated

Oct 30, 2024By 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

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifestream Behavioral Center IncGroup PAC ID 7012992720, 18 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.

• Lifestream Behavioral Center Inc

  • Psychiatric Hospital
  • Leesburg, FL
  • NPI 1902802002
  Medicare reassignment Care Compare group NPD
• Soleva Health & Wellness LLC

  • Health Service Clinic/Center
  • Apopka, FL
  • NPI 1356220313
  NPD Authorized official
• Lifestream Behavioral Center Inc

  • Primary Care Clinic/Center
  • Leesburg, FL
  • NPI 1659613776
  NPD

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1639759764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 BALTIC LN",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085161",
            "telephone_number": "917-698-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N 3RD ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485105",
            "telephone_number": "352-315-7900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1169 Baltic Ln",
            "address_purpose": "LOCATION",
            "city": "Winter Springs",
            "state": "FL",
            "postal_code": "327085161",
            "country_code": "US",
            "telephone_number": "917-698-9121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 E Magnolia Ave",
            "address_purpose": "LOCATION",
            "city": "Eustis",
            "state": "FL",
            "postal_code": "327263583",
            "country_code": "US",
            "telephone_number": "352-357-1550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "CHRYSTAL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11012141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanie Sherman, COTA/L
• Leah Marie Sherwood, AUD
• Tracy L Shipe, D.O.
• Janet Erickson Shipley, LMHC
• Shireen Dhanani DMD PA (The Dental Touch)
• Marielle Grace Shoffstall, LMT
• Ankita Shukla, PT DPT
• Kristen Siebecker, PT
• Stephen Joseph Signore, PA-C
• Sikkema Chiropractic PA

• Nurse Practitioner in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.