Individual provider Active NPI

Crystal Brittney Duncan, CRNP

  • Adult Health Nurse Practitioner
  • Pensacola, FL
National Provider Identifier
1891293932
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
11005771 Issued in FL
Practice address
2420 E Olive Rd Ste B
Pensacola, FL 32514-5110
Phone
(850) 332-6523
Fax
(850) 741-3679
NPI assigned
Jan 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1-111600 AL
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X 11005771 FL Primary

Addresses

Primary practice location

2420 E Olive Rd Ste B
Pensacola, FL 32514-5110

Mailing address

2420 E Olive Rd Ste B
Pensacola, FL 32514-5110
Phone (850) 332-6523

Other practice location 1

111 W Camphor Ave Ste 3
Foley, AL 36535-3519
Phone (850) 332-6523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20220422000148 AL Practitioner - Nurse Practitioner 0840687893 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-111600ALMDAdult Health Nurse Practitioner
11005771FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC Multi-Specialty CurrentSince Jan 1, 2022 Accepting new patients
Charlie Delta Health Service LLC CurrentSince Feb 4, 2024 Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

2420 E Olive Rd
Ste B
Pensacola, FL 32514
Phone (850) 332-6523

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25078/brand/1/csg/1/fhir/r4

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": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1891293932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 E OLIVE RD STE B",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325145110",
            "telephone_number": "850-332-6523",
            "fax_number": "850-741-3679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 E OLIVE RD STE B",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325145110",
            "telephone_number": "850-332-6523",
            "fax_number": "850-741-3679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 W Camphor Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Foley",
            "state": "AL",
            "postal_code": "365353519",
            "country_code": "US",
            "telephone_number": "850-332-6523",
            "fax_number": "850-741-3679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "CRYSTAL",
        "middle_name": "BRITTNEY",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-23",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-111600",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11005771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.