Individual provider Active NPI

Crystal Belle

  • Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1982235305
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP021482 Issued in PA
Practice address
828 Salem Ave
Hagerstown, MD 21740-4523
Phone
(301) 573-0965
NPI assigned
Feb 4, 2020
Last updated
Jun 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP021482 PA Primary

Addresses

Primary practice location

828 Salem Ave
Hagerstown, MD 21740-4523

Mailing address

828 Salem Ave
Hagerstown, MD 21740-4523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20241010002810 MD Practitioner - Nurse Practitioner 2163851981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sage Mental WellnessGroup PAC ID 6507254901, 4 clinicians

Practice addresses (Care Compare)

309 E Patrick St
Frederick, MD 21701-6792
Phone (240) 310-9962

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP021482PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Green Healing, LLC Current Accepting new patients
Sage Mental Wellness CurrentSince Jul 13, 2024 Accepting new patients

Locations

309 E Patrick St
Frederick, MD 21701
Phone (240) 310-9962

1190 Mount Aetna Rd
Ste 206
Hagerstown, MD 21740
Phone (240) 310-9961

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": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1982235305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 SALEM AVE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 SALEM AVE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404523",
            "telephone_number": "301-573-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLE",
        "first_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP021482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.