NPIMap

Individual provider Active NPI

Crystal Cornelia Maddox, M.D.

  • Family Medicine Physician
  • Gastonia, NC
National Provider Identifier
1942520937
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2011-01471 Issued in NC
Practice address
1895 Hoffman Road
Suite a
Gastonia, NC 28054-6557
Phone
(704) 865-1749
Fax
(704) 865-7328
NPI assigned
Jun 2, 2010
Last updated
Apr 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2011-01471 NC Primary

Addresses

Primary practice location

1895 Hoffman Road
Suite a
Gastonia, NC 28054-6557

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 834-2450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120911000313 NC Practitioner - Family Practice 0749438018 Reassigns benefits to 1 organization
I20220615002946 SC Practitioner - Family Practice 0749438018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, shared by 2 NPIs, 425 clinicians

Practice addresses (Care Compare)

1201 Village Harbor Dr
Suite 104
Lake Wylie, SC 29710-9276
Phone (803) 831-6859

1895 Hoffman Rd
Gastonia, NC 28054-6557

660 Summit Crossing PL
Suite 301
Gastonia, NC 28054-2181
Phone (704) 854-8799

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2011-01471NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Family Medicine Current Accepting new patients
Caromont Medical Group Inc Family Medicine Current Accepting new patients
Caromont Medical Group, Inc. Family Medicine CurrentSince Apr 20, 2022 Accepting new patients
Caromont Medical Group Inc Family Medicine CurrentSince Sep 16, 2013 Accepting new patients
Caromont Medical Group Inc Family Medicine Current Accepting new patients
Caromont Health Services, Inc. PastSince Jan 29, 2024 Accepting new patients

Locations

1895 Hoffman Rd
#A
Gastonia, NC 28054
Phone (704) 865-1749

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

1200 Village Harbor Dr
Ste D
Lake Wylie, SC 29710
Phone (704) 671-6400

1201 Village Harbor Dr
Ste 104
Lake Wylie, SC 29710
Phone (803) 831-6859

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Courtland TerraceGastonia, NC, CCN 345350 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 29, 2024
Feb 11, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1942520937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 HOFFMAN ROAD",
            "address_2": "SUITE A",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280546557",
            "telephone_number": "704-865-1749",
            "fax_number": "704-865-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "CRYSTAL",
        "middle_name": "CORNELIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2011-01471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.