Individual provider Active NPI

Krystal Danielle Sears, CRNP

  • Family Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1952578148
Registry record updated Oct 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-081723 Issued in AL
Practice address
600 Celebrate Life Pkwy
Newnan, GA 30265-8001
Phone
(770) 400-6000
NPI assigned
May 15, 2008
Last updated
Oct 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2017

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 1-081723 AL Primary

Addresses

Primary practice location

600 Celebrate Life Pkwy
Newnan, GA 30265-8001

Mailing address

600 Celebrate Life Pkwy
Newnan, GA 30265-8001
Phone (256) 282-3536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20141217001326 GA Practitioner - Nurse Practitioner 1456422534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Qcpi-Villagemd PCGroup PAC ID 8123389277, 76 clinicians

Practice addresses (Care Compare)

3334 Hwy 155
Suite B
Locust Grove, GA 30253
Phone (770) 305-7929

Merit-based Incentive Payment System (MIPS)

Final score
79.74 of 100Reported as group
Quality
63.81
Promoting interoperability
100
Improvement activities
40
Cost
57.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-081723ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Group of Georgia LLC CurrentSince Feb 14, 2018 Accepting new patients
Qcpi-Villagemd, PC CurrentSince Oct 14, 2024 Accepting new patients

Locations

3334 Highway 155
Ste 8
Locust Grove, GA 30248

3334 Highway 155
Ste B
Locust Grove, GA 30248
Phone (678) 284-0800

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

1805 Parke Plaza Cir
Ste 101
Stone Mtn, GA 30087
Phone (770) 469-7000

62742 Collections Ctr Dr
Chicago, IL 60693

Interoperability endpoints

  • Direct secure messaging: krystal.sears.1@21533.direct.athenahealth.com

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": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506988800000",
    "number": "1952578148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CELEBRATE LIFE PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658001",
            "telephone_number": "256-282-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CELEBRATE LIFE PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658001",
            "telephone_number": "770-400-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEARS",
        "first_name": "KRYSTAL",
        "middle_name": "DANIELLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-15",
        "last_updated": "2017-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-081723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.