Individual provider Active NPI

Crystal Ann Law

  • Family Nurse Practitioner
  • Wheeling, WV
National Provider Identifier
1932976396
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
117946 Issued in WV
Practice address
12 Elm Ter
Wheeling, WV 26003-5064
Phone
(304) 905-8695
NPI assigned
Dec 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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 117946 WV Primary

Addresses

Primary practice location

12 Elm Ter
Wheeling, WV 26003-5064

Mailing address

12 Elm Ter
Wheeling, WV 26003-5064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20240813000358 WV Practitioner - Nurse Practitioner 2668910431 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enlighten Health Care LLCGroup PAC ID 6800289372, 7 clinicians
Northwood Health Systems IncGroup PAC ID 4880600048, 14 clinicians

Practice addresses (Care Compare)

12 Elm Ter
Wheeling, WV 26003-5064
Phone (304) 374-5603

1819 Wood St
Wheeling, WV 26003-3607
Phone 30423435002282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
117946WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Enlighten Health Care, LLC Family CurrentSince Apr 15, 2024 Accepting new patients

Locations

12 Elm Ter
Wheeling, WV 26003
Phone (304) 374-5603

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": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1932976396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ELM TER",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260035064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ELM TER",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260035064",
            "telephone_number": "304-905-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAW",
        "first_name": "CRYSTAL",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-06",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "117946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.