Phoenix Medical Group PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PHOENIX MEDICAL GROUP PLLC

Practice address

11357 Nuckols Rd # 2091
Glen Allen, VA 23059-5504

Phone

(804) 624-9917

Fax

(804) 729-5887

NPI assigned

Feb 13, 2022

Organization subpart

No

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

Authorized official

Name

Miss Deborah Crutchfield, DNP, PMHNP-BC

Title

Owner

Phone

(804) 965-4327

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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

{
    "created_epoch": "1644710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1730834326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11357 NUCKOLS RD # 2091",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595504",
            "telephone_number": "804-965-4327",
            "fax_number": "804-729-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11357 NUCKOLS RD # 2091",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595504",
            "telephone_number": "804-624-9917",
            "fax_number": "804-729-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-13",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "CRUTCHFIELD",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-965-4327",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "DNP, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.