Crystal Y Clark-Crookshanks, FNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

APRN63168 Issued in WV

Practice address

131 Wellness Dr
Summersville, WV 26651-5402

Phone

(888) 736-3229

NPI assigned

Apr 18, 2012

Last updated

Jul 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Seneca Health Services IncGroup PAC ID 8022005263, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Seneca Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Maxwelton, WV
  • NPI 1154532513
  Medicare reassignment Care Compare group NPD
• Seneca Health Services, Inc.

  • Family Medicine Physician
  • Maxwelton, WV
  • NPI 1235838954
  NPD
• Seneca Health Services Inc

  • Community/Behavioral Health Agency
  • Maxwelton, WV
  • NPI 1245441609
  NPD (past)

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1942567763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 WELLNESS DR",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266515402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 WELLNESS DR",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266515402",
            "telephone_number": "888-736-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK-CROOKSHANKS",
        "first_name": "CRYSTAL",
        "middle_name": "Y",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "63168",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WV",
            "license": "APRN63168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charleston Area Medical Center, Inc.
• Lindsey Rose Cherilla
• Aaron Josiah Cherry
• Cheryl Childers, RN,BSN
• Lauren Clagg
• Vesta Clark
• Clay Co. Dev (Tender Heart)
• April D Clendenin, SCHOOL PSYCHOLOGIST
• John Morgan Cline, O.D.
• Eelijah Jamison Clutter

• Primary Care Nurse Practitioner in Summersville, WV
• Providers in Summersville, WV by specialty
• Primary Care Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.