Individual provider Active NPI

Crystal A Hearn

  • Massage Therapist
  • Wilmington, DE
National Provider Identifier
1689247405
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT-0015110 Issued in DE
Practice address
1702 Kirkwood Hwy Ste 101
Wilmington, DE 19805-4939
Phone
(302) 777-0778
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X MT-0015110 DE Primary

Addresses

Primary practice location

1702 Kirkwood Hwy Ste 101
Wilmington, DE 19805-4939

Mailing address

1702 Kirkwood Hwy Ste 101
Wilmington, DE 19805-4939
Phone (302) 777-0778

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

State licenses

LicenseStateTypeSpecialty
MT-0015110DEMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vitality Chiropractic and Rehabilitation LLC Multi-Specialty CurrentSince Mar 3, 2024 Accepting new patients

Locations

1702 Kirkwood Hwy
Ste 101
Wilmington, DE 19805
Phone (302) 507-1075

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1689247405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 KIRKWOOD HWY STE 101",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054939",
            "telephone_number": "302-777-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 KIRKWOOD HWY STE 101",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198054939",
            "telephone_number": "302-777-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARN",
        "first_name": "CRYSTAL",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "DE",
            "license": "MT-0015110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.