Crystal Martinez, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5011600 Issued in NC

Practice address

3151 Dallas High Shoals Hwy Unit 935
Dallas, NC 28034-1369

Phone

(803) 470-5358

NPI assigned

Feb 5, 2019

Last updated

Sep 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 NC

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Odin Healthcare PLLC

  dba Zen Mind OHC

  • Family Nurse Practitioner
  • Dallas, NC
  • NPI 1538805239
  Medicare reassignment NPD Authorized official
• Coastal Southeastern United Care LLC

  dba Coastal Southeastern United Care

  • Community/Behavioral Health Agency
  • Supply, NC
  • NPI 1346477403
  Medicare reassignment NPD
• Whiteville Mat Services, Inc.

  • Methadone Clinic
  • Whiteville, NC
  • NPI 1740868744
  NPD (past)
• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1801355482
  NPD (past)

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1972068757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 DALLAS HIGH SHOALS HWY UNIT 935",
            "city": "DALLAS",
            "state": "NC",
            "postal_code": "280341369",
            "telephone_number": "803-470-5358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 DALLAS HIGH SHOALS HWY UNIT 935",
            "city": "DALLAS",
            "state": "NC",
            "postal_code": "280341369",
            "telephone_number": "803-470-5358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "CRYSTAL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "289876",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5011600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liberty Living, Inc
• Alice Jordan Lindo, LMHCA
• Meagan Lohr
• Maidtrix LLC
• Rebecca Mae Mapel, PHARM D
• Ashish Mehta
• Miata Mobile Hearing AIDS LLP
• Allyson Beth Middleton, PHARMD
• Mark Walter Miller, PHARMD
• Robert John Miller, RPH

• Psychiatric/Mental Health Nurse Practitioner in Dallas, NC
• Providers in Dallas, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.