Individual provider Active NPI

Crystal Lynnette Minor, WHNP-BC

  • Women's Health Nurse Practitioner
  • Oxford, NC
National Provider Identifier
1750927893
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
MINO-A511SW Issued in NC
Practice address
1209 SE Industry Dr
Oxford, NC 27565-5023
Phone
(252) 492-8576
NPI assigned
Nov 25, 2019
Last updated
Nov 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X MINO-A511SW NC Primary

Addresses

Primary practice location

1209 SE Industry Dr
Oxford, NC 27565-5023

Mailing address

1209 SE Industry Dr
Oxford, NC 27565-5023
Phone (252) 492-8576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200331000527 NC Practitioner - Nurse Practitioner 7416386248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 Charles Rollins Rd
Suite 105
Henderson, NC 27536-2882
Phone (252) 438-2773

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
MINO-A511SWNCMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Maria Parham Physician Practices, LLC Current Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Mar 9, 2020 Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Mar 9, 2020 Accepting new patients
DLP Maria Parham Physician Practices, LLC Past Accepting new patients

Locations

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

568 Ruin Creek Rd
Ste 1
Henderson, NC 27536
Phone (252) 438-7102

568 Ruin Creek Rd
Ste 6
Henderson, NC 27536
Phone (252) 436-1085

1501 N Bickett Blvd
Ste E
Louisburg, NC 27549
Phone (919) 497-0445

1209 SE Industry Dr
Oxford, NC 27565
Phone (252) 492-8576

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: crystal.minor.1@20247.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1750927893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 SE INDUSTRY DR",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275655023",
            "telephone_number": "252-492-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 SE INDUSTRY DR",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275655023",
            "telephone_number": "252-492-8576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "CRYSTAL",
        "middle_name": "LYNNETTE",
        "name_prefix": "Mrs.",
        "credential": "WHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NC",
            "license": "MINO-A511SW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, NC

Sources for this page

Verify at the official NPI Registry.