Crystal Michelle Boggs, FNP
Individual provider Active NPI Family Nurse Practitioner · Harrisburg, NC
NPI 1780267484 · NPPES record last updated Jul 15, 2024
Key facts
- NPI
- 1780267484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5015587 (NC)
- Practice address
- 4315 Physicians Blvd
Ste 101
Harrisburg, NC 28075-7430 - Phone
- (704) 455-6521
- NPI assigned
- Apr 30, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Carolinas Physicians Network Inc
Carolina Physical Therapy Associates LLC
Practice addresses (Care Compare)
5727 Prosperity Crossing Dr
Suite 2200
Charlotte, NC 28269-0034
Phone (704) 863-9830
6604 Roberta Rd
Harrisburg, NC 28075-9532
Phone (419) 221-6717
Hospital & facility affiliations
- Carolinas Medical Center/Behav Health
- Carolinas Medical Center-Northeast
Merit-based Incentive Payment System (MIPS)
- Final score
- 94 of 100
- Quality
- 81.63
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220914000417 | NC | Practitioner - Nurse Practitioner | 3173908019 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5015587 | NC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Physicians Network Inc | Current |
Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current |
Accepting new patients | |
| Carolinas Physicians Network Inc | Past | Accepting new patients |
Locations
100 N 6th St
Ste 900A
Minneapolis, MN 55403
5727 Prosperity Crossing Dr
Ste 2200
Charlotte, NC 28269
Phone (704) 618-7894
5651 Poplar Tent Rd
Ste 102
Concord, NC 28027
Phone (704) 782-4878
270 Copperfield Blvd NE
Ste 102
Concord, NC 28025
Phone (704) 721-2060
4315 Physicians Blvd
Ste 101
Harrisburg, NC 28075
Phone (704) 455-6521
123 Professional Park Dr
Locust, NC 28097
Phone (704) 403-6760
8560 Cook St
Mt Pleasant, NC 28124
Phone (704) 403-1911
Interoperability endpoints
- cboggs224772@carolinashealthcaresystem.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5015587 | NC | |
| Family Nurse Practitioner | 363LF0000X | 5015587 | NC | Yes |
Addresses
Primary practice location
4315 Physicians Blvd
Ste 101
Harrisburg, NC 28075-7430
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
5651 Poplar Tent Rd
Ste 102
Concord, NC 28027-7686
Phone (704) 863-4878
Other practice location 2
270 Copperfield Blvd NE
Ste 102
Concord, NC 28025-2441
Phone (704) 786-6521
Other practice location 3
123 Professional Park Dr
Locust, NC 28097-7712
Phone (704) 403-6760
Other practice location 4
8560 Cook St
Mount Pleasant, NC 28124-7686
Phone (704) 436-6521
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cboggs224772@CarolinasHealthcareSystem.direct-ci.com | Atrium Health | |
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
Other providers in Harrisburg, NC
- Colleen Rochelle Black
- Tanika Blackmon
- Esther Lavenia Blanks-Sheard
- Blue Rabbit Logistics & Solutions LLC
- Tyeekia Blue
- Jennifer Bourbonnais
- Julia Kihm Bregenzer
- Stephanie Nichol Briscoe
- Fredericka Brooks
- Linda Brown
All providers in Harrisburg, NC · Family Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.