Individual provider Active NPI

Crystal Gale McGlothlin, FNP

  • Nurse Practitioner
  • Cedar Bluff, VA
National Provider Identifier
1689801425
Registry record updated Jun 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024168333 Issued in VA
Practice address
113 Cumberland Road
Cedar Bluff, VA 24609-0810
Phone
(276) 964-6702
Fax
(276) 964-5669
NPI assigned
Jun 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024168333 VA Primary

Addresses

Primary practice location

113 Cumberland Road
Cedar Bluff, VA 24609-0810

Mailing address

PO Box 810
Cedar Bluff, VA 24609-0810
Phone (276) 964-6702

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024168333VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Connect America, Inc Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cmcglothlin@direct.hcacorp.net

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": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245369600000",
    "number": "1689801425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "246090810",
            "telephone_number": "276-964-6702",
            "fax_number": "276-964-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 CUMBERLAND ROAD",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "246090810",
            "telephone_number": "276-964-6702",
            "fax_number": "276-964-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGLOTHLIN",
        "first_name": "CRYSTAL",
        "middle_name": "GALE",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2009-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024168333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Bluff, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; 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.