Crystal De' Jean Heathington, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

903121 Issued in MS

Practice address

428 Courthouse Rd Ste B
Gulfport, MS 39507-1868

Phone

(228) 207-0408

Fax

(228) 207-0409

NPI assigned

Jan 27, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, AL2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 33)

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.

• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• FBL Physicians, P.C.

  • Obstetrics & Gynecology Physician
  • Mobile, AL
  • NPI 1780468108
  Medicare reassignment NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  MS, Nurse Practitioner

  Medicare reassignment NPD
• Elite Health Clinic, LLC

  • Women's Health Clinical Nurse Specialist
  • Gulfport, MS
  • NPI 1538752084
  NPD Authorized official
• Donna E Alexander MD Obstetrics and Gynecology LLC

  • Obstetrics & Gynecology Physician
  • Biloxi, MS
  • NPI 1609129808
  NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD
• Center for OB-GYN PLLC

  • Obstetrics & Gynecology Physician
  • Ocean Springs, MS
  • NPI 1548416779
  NPD (past)

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

{
    "created_epoch": "1548547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1992269617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 COURTHOUSE RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395071867",
            "telephone_number": "228-207-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 COURTHOUSE RD STE B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395071868",
            "telephone_number": "228-207-0408",
            "fax_number": "228-207-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATHINGTON",
        "first_name": "CRYSTAL",
        "middle_name": "DE' JEAN",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-27",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "903121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.