Individual provider Active NPI

Crystal Legayle Parks, D.O.

  • Family Medicine Physician
  • Semmes, AL
National Provider Identifier
1760748172
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO.1645 Issued in AL
Practice address
8010 Moffett Rd
Semmes, AL 36575-5406
Phone
(251) 645-8946
Fax
(251) 645-8976
NPI assigned
Apr 10, 2012
Last updated
Jan 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO.1645 AL Primary

Addresses

Primary practice location

8010 Moffett Rd
Semmes, AL 36575-5406

Mailing address

6701 Airport Blvd Ste D143
Mobile, AL 36608-6701
Phone (251) 342-3949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160930000388 AL Practitioner - Family Practice 4981991262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Homeopathic Medicine, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3929 Airport Blvd
FL 5
Mobile, AL 36609-1987

PO Box
Suite 850489
Mobile, AL 36685-0489

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO.1645ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Providence Healthcare Services Family Medicine CurrentSince Aug 1, 2016 Accepting new patients
Alabama Providence Healthcare Services Family Medicine Current Accepting new patients
Providence Healthcare Services Family Medicine Current Accepting new patients
Alabama Providence Healthcare Services CurrentSince Aug 1, 2016 Accepting new patients
USA Health Community Providers LLC Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
University of South Alabama Mitchell Cancer Institute Past Accepting new patients

Locations

6701 Airport Blvd
Ste A101
Mobile, AL 36608
Phone (251) 633-8880

6701 Airport Blvd
Ste B329
Mobile, AL 36608
Phone (251) 633-4311

6801 Airport Blvd
Mobile, AL 36608
Phone (251) 266-3580

8010 Moffett Rd
Semmes, AL 36575
Phone (251) 645-8946

Interoperability endpoints

  • Direct secure messaging: crystal.parks.1@16253.direct.athenahealth.com

Organizations & group practices 6

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 2

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1760748172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD STE D143",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366086701",
            "telephone_number": "251-342-3949",
            "fax_number": "251-266-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8010 MOFFETT RD",
            "city": "SEMMES",
            "state": "AL",
            "postal_code": "365755406",
            "telephone_number": "251-645-8946",
            "fax_number": "251-645-8976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "CRYSTAL",
        "middle_name": "LEGAYLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO.1645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Semmes, AL

Sources for this page

Verify at the official NPI Registry.