Crystal St. Fort, NP

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

SP029428 Issued in PA

Practice address

142 S 60TH St Unit a
Philadelphia, PA 19139-3038

Phone

(215) 495-5846

NPI assigned

May 11, 2024

Last updated

May 11, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1715385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715385600000",
    "number": "1871341073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 S 60TH ST UNIT A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393038",
            "telephone_number": "215-495-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 S 60TH ST UNIT A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393038",
            "telephone_number": "215-495-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. FORT",
        "first_name": "CRYSTAL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-11",
        "last_updated": "2024-05-11",
        "certification_date": "2024-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "PA",
            "license": "SP029428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Christopher's Pediatric Associates
• St. Christopher's Pediatric Associates
• St. Christopher's Physician Associates, LLC
• Eric St. Clair, M.D.
• Grace Catherine St. Cyr, MD
• St. Francis Clinic
• St. Francis-St. Joseph Homes for Children
• Regine St. Germain, PHARMD
• Jessica Lenoir St. Jacobs, LPC
• St. James School

• Procedural Dermatology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Procedural Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2024; 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.