Active NPI
Crystal Ann Jennings
- Nurse's Aide
- Rock Hill, SC
National Provider Identifier
1891313730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 166695
- Practice address
- 331 E. Main St., Suite 200
Rock Hill, SC 29730 - Phone
- (803) 909-9598
- Fax
- (803) 909-9301
- NPI assigned
- Jul 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | IHCP-1594 | SC | |
| Community Health Worker | 172V00000X | |||
| Health Educator | 174H00000X | |||
| Phlebotomy Technician | 246RP1900X | |||
| Home Health Agency | 251E00000X | |||
| Community Based Hospice Care Agency | 251G00000X | |||
| Assisted Living Facility | 310400000X | |||
| Non-emergency Medical Transport (VAN) | 343900000X | |||
| Adult Companion | 372600000X | |||
| Personal Care Attendant | 3747P1801X | |||
| Home Health Aide | 374U00000X | |||
| Respite Care | 385H00000X | |||
| Child Physical Disabilities Respite Care | 385HR2065X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Nurse's Aide | 376K00000X | 166695 | SC | Primary |
Addresses
Primary practice location
331 E. Main St., Suite 200
Rock Hill, SC 29730
Mailing address
331 E Main St Ste 200
Rock Hill, SC 29730-5384
Phone (803) 909-9598
Other practice location 1
322 Woodcrest Dr
York, SC 29745-2669
Phone (803) 616-3269
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 166696 | Other | SC | CNA |
| 419524 | Other | NC | CNA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ceo@christalshomeservices.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IHCP-1594 | SC | MD | Contractor |
| 166695 | SC | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661385600000",
"number": "1891313730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "331 E MAIN ST STE 200",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297305384",
"telephone_number": "803-909-9598",
"fax_number": "803-909-9301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "331 E. MAIN ST., SUITE 200",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "29730",
"telephone_number": "803-909-9598",
"fax_number": "803-909-9301"
}
],
"practiceLocations": [
{
"address_1": "322 Woodcrest Dr",
"address_purpose": "LOCATION",
"city": "York",
"state": "SC",
"postal_code": "297452669",
"country_code": "US",
"telephone_number": "803-616-3269",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JENNINGS",
"first_name": "CRYSTAL",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-08",
"last_updated": "2022-08-25",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "SC",
"license": "IHCP-1594",
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": false
},
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": null,
"license": null,
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2065X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Physical Disabilities, Child",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "SC",
"license": "166695",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CNA",
"identifier": "166696",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CNA",
"identifier": "419524",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ceo@christalshomeservices.com",
"affiliation": "N",
"endpointDescription": "Email Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "331 E Main St Ste 200",
"city": "Rock Hill",
"state": "SC",
"country_code": "US",
"postal_code": "297305384",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Rock Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.