Krystal L Pusser, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001348 Issued in GA

Practice address

2817 Reilly St
Womack Army Medical Center
Fort Bragg, NC 28310-7324

Phone

(910) 907-8922

Fax

(910) 907-6069

NPI assigned

Jul 4, 2006

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

Other identifiers 13

Other names 1

• Krystal P Bragg Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1992735815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "address_2": "WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107324",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "address_2": "WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107324",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSSER",
        "first_name": "KRYSTAL",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - RINCON",
            "identifier": "000606537H",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "1992735815",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000606537F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID- BORO",
            "identifier": "000606537G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATL VISION ADMIN",
            "identifier": "111065",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "732348",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000606537D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000606537A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000606537E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "08525",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE HEALTH PLAN",
            "identifier": "52484359",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00013749",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA MEDICARE GROUP",
            "identifier": "511G701032",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTAL",
            "last_name": "BRAGG",
            "middle_name": "P",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sunny Provence, FNP
• Allison Marie Pruett
• Jenna Przybylowski
• Richard Spencer Purdham, RN, CRNA
• Rishi Purohit, DMD
• Caroline Michaela Pyzdrowski, PT
• Robert Quarcoo, D.O
• Jena N Queen, LAT
• Annmarie Dora Quilty, OTR/L
• Katherine E Quin, LCSW

• Optometrist in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.