Crystal L Dillard, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1545 Issued in AL

Practice address

1600 7TH Ave S
Acc 500
Birmingham, AL 35233-1711

Phone

(205) 939-9193

Fax

(205) 939-9949

NPI assigned

Sep 19, 2008

Last updated

Mar 26, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: crystal.dillard.p2@direct.umc.nextgenshare.com

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.

• Capstone Health Services Foundation PC

  dba University Medical Center

  • Family Medicine Physician
  • Tuscaloosa, AL
  • NPI 1740397751
  Medicare reassignment NPD
• Capstone Health Services Foundation PC

  dba University Medical Center Neurology

  • Neurology Physician
  • Tuscaloosa, AL
  • NPI 1255212353
  NPD
• University of Tennessee

  dba Center on Developmental Disabilities

  • Developmental Disabilities Clinic/Center
  • Memphis, TN
  • NPI 1427064880
  NPD (past)

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269561600000",
    "number": "1679723241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407 DRAWER 1492",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352461492",
            "telephone_number": "205-939-9193",
            "fax_number": "205-939-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S",
            "address_2": "ACC 500",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-939-9193",
            "fax_number": "205-939-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "CRYSTAL",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-19",
        "last_updated": "2010-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AL",
            "license": "1545",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1545",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "TN",
            "license": "2829",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "515-97317",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BC",
            "identifier": "515-98119",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE SOUTH",
            "identifier": "1679723241",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "515-97316",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BC",
            "identifier": "515-98120",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109018",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109021",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Digital Care Team of Al, LLC (247DCT)
• Jerry Matthew Digman, M.D.
• Chinenye Rebecca Dike, M.D
• Rachael Dike, DO
• Amber Dill
• Cynthia F Dillard, CRNA
• Emily Rae Dillard, PA
• Freddy B Dillard Jr., PA-C
• Makena Grace Dillashaw
• Kayce Dillon

• Psychologist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Psychologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.