Individual provider Active NPI

Crystal Ritchie Thornton, NP-C

  • Family Nurse Practitioner
  • Garner, NC
National Provider Identifier
1932339215
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F0609130 Issued in NC
Practice address
958 Vandora Springs Rd
Garner, NC 27529-3544
Phone
(919) 772-3587
Fax
(919) 772-3446
NPI assigned
Jul 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F0609130 NC Primary

Addresses

Primary practice location

958 Vandora Springs Rd
Garner, NC 27529-3544

Mailing address

501 Health Park Dr
Ste 150
Garner, NC 27529-7051
Phone (919) 772-3487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160115001045 NC Practitioner - Nurse Practitioner 0941503437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Care of Charlotte PAGroup PAC ID 7911906151, 10 clinicians

Practice addresses (Care Compare)

15830 Ballantyne Medical PL
Suite 100
Charlotte, NC 28277-0762
Phone (704) 341-0090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F0609130NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Care of Charlotte, PA CurrentSince May 1, 2021 Accepting new patients
Anne Arundel Dermatology Affiliates PC Past Accepting new patients

Locations

15830 Ballantyne Medical Pl
Ste 100
Charlotte, NC 28277
Phone (704) 341-0090

6040 W Highway 74
Indian Trail, NC 28079

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1932339215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 HEALTH PARK DR",
            "address_2": "STE 150",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275297051",
            "telephone_number": "919-772-3487",
            "fax_number": "919-772-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "958 VANDORA SPRINGS RD",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275293544",
            "telephone_number": "919-772-3587",
            "fax_number": "919-772-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "CRYSTAL",
        "middle_name": "RITCHIE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-21",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F0609130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garner, NC

Sources for this page

Verify at the official NPI Registry.