Crystal Lynn Miller, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

316083-1 Issued in NY

Practice address

4851 Rich Rd
Morrisville, NY 13408

Phone

(315) 893-7040

NPI assigned

Apr 13, 2015

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

Other names 1

• Mrs. Crystal Lynn Fannin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1669868055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 STATE RT 46",
            "city": "BOUCKVILLE",
            "state": "NY",
            "postal_code": "13310",
            "telephone_number": "315-893-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4851 RICH RD",
            "city": "MORRISVILLE",
            "state": "NY",
            "postal_code": "13408",
            "telephone_number": "315-893-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CRYSTAL",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "316083-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "FANNIN",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Soren A Johnson
• Todd Kleinhans, ATC
• Anne Kramer-McGinn, LPN
• Christine C Merritt, NP
• Melissa Middlebrook, LMSW
• Morrisville Physical Therapy PLLC
• Morrisville-Eaton Central School
• Mark Edward Nowakowski, LMSW
• Mark E Ohl, MD
• Lorie K Pearsall, LMT

• All providers in Morrisville, NY
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.