Individual provider Active NPI

Crystal Satona Quince, MBA,PNHNP-BC,FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Pierce, FL
National Provider Identifier
1972605202
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2021013806 Issued in FL
Practice address
5000 W Midway Road
Unit 13317
Fort Pierce, FL 34981-1900
Phone
(877) 825-7846
Fax
(877) 881-1049
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2021013806 FL Primary
Family Medicine Physician 207Q00000X APRN9290324 FL
Nurse Practitioner 363L00000X 2018004992 FL

Addresses

Primary practice location

5000 W Midway Road
Unit 13317
Fort Pierce, FL 34981-1900

Mailing address

5000 W Midway Rd # 13317
Fort Pierce, FL 34981-4827
Phone (833) 379-1898

Other identifiers 5

IdentifierTypeStateIssuer
APRN9290324OtherFLAPRN
200002639OtherDCAPRN
822600-01OtherNYAPRN
61183806OtherWAAPRN
GAA-NP00017OtherGAAPRN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220106002898 FL Practitioner - Nurse Practitioner 1557752219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

417 SW Park St
Okeechobee, FL 34972-4164
Phone (877) 825-7846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9290324FLMDFamily Medicine Physician
2018004992FLMDNurse Practitioner
2021013806FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Talquin Inc Nurse Practitioner CurrentSince Oct 15, 2021 Accepting new patients
Baba Healthcare Past Accepting new patients

Locations

5000 W Midway Rd
Unit 13317
Fort Pierce, FL 34979

5000 W Midway Rd
Unit 13317
Fort Pierce, FL 34981
Phone (877) 825-7846

5000 W Midway Rd
Unit 12190
Fort Pierce, FL 34981
Phone (772) 310-8591

1713 US Highway 441 N
Ste E
Okeechobee, FL 34972
Phone (561) 312-8615

417 SW Park St
Okeechobee, FL 34972
Phone (877) 825-7846

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.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1972605202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 W MIDWAY RD # 13317",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349814827",
            "telephone_number": "833-379-1898",
            "fax_number": "877-881-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W MIDWAY ROAD",
            "address_2": "UNIT 13317",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349811900",
            "telephone_number": "877-825-7846",
            "fax_number": "877-881-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINCE",
        "first_name": "CRYSTAL",
        "middle_name": "SATONA",
        "name_prefix": "Ms.",
        "credential": "MBA,PNHNP-BC,FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "2021013806",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "APRN9290324",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "2018004992",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "APRN9290324",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "200002639",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "822600-01",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "61183806",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "GAA-NP00017",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.