Active NPI
Crystal Shore
- In Home Supportive Care Agency
- Henderson, NV
National Provider Identifier
1992429864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Practice address
- 372 El Pico Dr
Henderson, NV 89014-3514 - Phone
- (661) 433-9806
- NPI assigned
- Oct 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
372 El Pico Dr
Henderson, NV 89014-3514
Mailing address
372 El Pico Dr
Henderson, NV 89014-3514
Phone (661) 433-9806
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | crystaljshore5@gmail.com |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664755200000",
"number": "1992429864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "372 EL PICO DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890143514",
"telephone_number": "661-433-9806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "372 EL PICO DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890143514",
"telephone_number": "661-433-9806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORE",
"first_name": "CRYSTAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-03",
"last_updated": "2022-10-03",
"certification_date": "2022-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "crystaljshore5@gmail.com",
"affiliation": "N",
"address_1": "372 El Pico Dr",
"city": "Henderson",
"state": "NV",
"country_code": "US",
"postal_code": "890143514",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.