Active NPI
Crystal Martin, PHARM.D.
- Pharmacist
- Placerville, CA
National Provider Identifier
1962769596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 61120
- Practice address
- 4220 Missouri Flat Rd
Placerville, CA 95667-6269 - Phone
- (530) 344-1062
- Fax
- (530) 344-1068
- NPI assigned
- Apr 20, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 61120 | CA | Primary |
Addresses
Primary practice location
4220 Missouri Flat Rd
Placerville, CA 95667-6269
Mailing address
4220 Missouri Flat Rd
Placerville, CA 95667-6269
Phone (530) 344-1062
Other names 1
- Ms. Crystal Sanders
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co. | Past | Accepting new patients |
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.
-
- Pharmacy
- Placerville, CA
- NPI 1689903825
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334880000000",
"number": "1962769596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4220 MISSOURI FLAT RD",
"city": "PLACERVILLE",
"state": "CA",
"postal_code": "956676269",
"telephone_number": "530-344-1062",
"fax_number": "530-344-1068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4220 MISSOURI FLAT RD",
"city": "PLACERVILLE",
"state": "CA",
"postal_code": "956676269",
"telephone_number": "530-344-1062",
"fax_number": "530-344-1068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "CRYSTAL",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-20",
"last_updated": "2012-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "61120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CRYSTAL",
"last_name": "SANDERS",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Placerville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.