Crystal Smith

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

000000 Issued in TX

Practice address

6115 Camp Bowie Blvd Ste 290
Ft Worth, TX 76116-5500

Phone

(817) 831-1105

NPI assigned

Jan 16, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• First Choice Children'S Homecare, LP

  • Home Health Agency
  • Dallas, TX
  • NPI 1164053278
  NPD (past)

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1780158469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6115 CAMP BOWIE BLVD",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761165512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 CAMP BOWIE BLVD STE 290",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761165500",
            "telephone_number": "817-831-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Nothing",
            "affiliation": "N",
            "address_1": "6115 Camp Bowie Blvd Ste 290",
            "city": "Ft Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761165500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Caylee Jordan Smith, D.C
• Chanel Mone Smith, PT, DPT
• Chera M Smith, PA-C
• Claire Smith, MS, CCC-SLP
• Cody Wayne Smith, CST, CSFA
• Damian Smith, PHARM D
• Danica Larissa Smith
• Daniel Jacob Smith, DO
• Danielle Elizabeth Smith, DO
• David Allen Smith, LCDC

• Registered Nurse in Ft Worth, TX
• Providers in Ft Worth, TX by specialty
• Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.