Individual provider Active NPI

Crystal Marie Venturino, D.C.

  • Chiropractor
  • Tampa, FL
National Provider Identifier
1851905871
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH13129 Issued in FL
Practice address
14491 University Cove PL
Tampa, FL 33613-3741
Phone
(813) 977-2383
Fax
(813) 977-2585
NPI assigned
Sep 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CH13129 FL Primary

Addresses

Primary practice location

14491 University Cove PL
Tampa, FL 33613-3741

Mailing address

14491 University Cove PL
Tampa, FL 33613-3741
Phone (813) 977-2383

Other names 1

  • Crystal Marie Burgos Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201027000745 FL Practitioner - Chiropractic 8022438308 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH13129FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Venturino DC LLC Chiropractor CurrentSince Oct 1, 2020 Accepting new patients

Locations

14491 University Cove Pl
Tampa, FL 33613
Phone (813) 977-2383

11730 N Dale Mabry Hwy
Ste A
Tampa, FL 33618
Phone (813) 308-9116

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1851905871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14491 UNIVERSITY COVE PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133741",
            "telephone_number": "813-977-2383",
            "fax_number": "813-977-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14491 UNIVERSITY COVE PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133741",
            "telephone_number": "813-977-2383",
            "fax_number": "813-977-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTURINO",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "BURGOS",
            "middle_name": "MARIE",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.