Individual provider Active NPI

Crystal Lynn Richardson, FNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Sanford, NC
National Provider Identifier
1780245662
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
5011947 Issued in NC
Practice address
127 N Steele St
Sanford, NC 27330-3917
Phone
(919) 776-7640
NPI assigned
Jun 22, 2019
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RICH-OW8RAX NC
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 5011947 NC Primary

Addresses

Primary practice location

127 N Steele St
Sanford, NC 27330-3917

Mailing address

127 N Steele St
Sanford, NC 27330-3917
Phone (919) 776-7640

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
I20210914000074 NC Practitioner - Nurse Practitioner 9133525371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

127 N Steele St
Sanford, NC 27330-3917
Phone (919) 776-7640

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RICH-OW8RAXNCMDNurse Practitioner
5011947NCMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Central Carolina Medical Group LLC Current Accepting new patients
DLP Central Carolina Medical Group LLC CurrentSince Jul 26, 2023 Accepting new patients
DLP Central Carolina Medical Group LLC CurrentSince Jul 26, 2023 Accepting new patients
DLP Central Carolina Medical Group LLC Nurse Practitioner Past Accepting new patients

Locations

75 Old Graham Rd
Pittsboro, NC 27312
Phone (919) 542-2731

1140 Carthage St
Ste A
Sanford, NC 27330
Phone (919) 775-2304

127 N Steele St
Sanford, NC 27330
Phone (919) 776-7640

Interoperability endpoints

  • Direct secure messaging: crystal.richardson.1@15593.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 1

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": "1561161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1780245662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 N STEELE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273303917",
            "telephone_number": "919-776-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 N STEELE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273303917",
            "telephone_number": "919-776-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "CRYSTAL",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-22",
        "last_updated": "2023-09-11",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "RICH-OW8RAX",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NC",
            "license": "5011947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

Verify at the official NPI Registry.