MRS. CRYSTAL SMITH (NPI# 1356389514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356389514 |
| Entity Type | Individual |
| Full Name | MRS. CRYSTAL SMITH |
| Credential | PA |
| Practice Address |
509 Memorial Dr Suite 2 Manchester KY 40962-6195 |
| Mailing Address |
509 Memorial Dr Ste 2 Manchester KY 40962-6196 |
| Practice Telephone | 6065988813 |
| Practice Fax Number | 6065981688 |
| Mailing Telephone | 6065988813 |
| Mailing Fax Number | 6065981688 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2020-01-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA792 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | ANTHEM BCBS | 000000522080 | 01 |
| KY | 95003737 | 05 | |
| RR MEDICARE | P00648835 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548724974 | Crystal K Smith | Adult Companion | 508 64th Ave E, Bradenton, FL 34203-7643 | 2019-01-30 |
| 1619499647 | Crystal Marie Smith | Nurse Practitioner | 2401 Brandermill Blvd Ste 310, Gambrills, MD 21054-1604 | 2017-07-12 |
| 1699147322 | Crystal P Smith | Occupational Therapy Assistant | 4217 Peppertree Ave, Concord, NC 28027-7670 | 2015-10-21 |
| 1003234147 | Crystal Smith | Homeopath | 6923 Coleshire Dr, Dallas, TX 75232 | 2014-04-05 |
| 1386076602 | Crystal Eva Smith | Counselor | 1900 Kinmount Dr, Lake Orion, MI 48359-1639 | 2013-08-09 |
| 1255661807 | Crystal Irene Smith | Physical Therapist | 801 Carrington Ave, Capitol Heights, MD 20743-1846 | 2010-01-04 |
| 1790852846 | Crystal D Smith | Counselor | 520 Mount Rose St, Reno, NV 89509-3362 | 2006-11-30 |
| 1831175769 | Crystal Jo Smith | Dentist | Bldg 38801 Academic Dr, Suite B & C, Ft Gordon, GA 30905-5660 | 2005-12-22 |
| 1679172340 | Crystal Elizabeth Smith | Behavior Technician | 3245 Keewahdin Rd, Fort Gratiot, MI 48059-3498 | 2020-10-22 |
| 1144837808 | Crystal Smith | Homemaker | 103 W 5th Ave, Ranson, WV 25438-1405 | 2020-09-28 |
| Street Address |
509 MEMORIAL DR SUITE 2 |
| City | MANCHESTER |
| State | KY |
| Zip Code | 40962-6195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811941008 | Steven D. Spady | Clinic/Center | 509 Memorial Dr, Suite 2, Manchester, KY 40962-6195 | 2006-05-20 |
| 1194195230 | Gloria Zerbee | Nurse Practitioner | 509 Memorial Dr, Suite 2, Manchester, KY 40962-6195 | 2015-10-01 |
| 1992041131 | Clay Medi Center Pharmacy LLC | Pharmacy | 509 Memorial Dr, Manchester, KY 40962-6195 | 2012-12-17 |
| 1275856247 | Diabetic Health, Inc. | Registered Nurse | 509 Memorial Dr, Suite 2, Manchester, KY 40962-6195 | 2010-03-05 |
| 1457592693 | Memorial Hospital, Inc. | Internal Medicine | 509 Memorial Dr, Suite 2, Manchester, KY 40962-6195 | 2009-03-18 |
| 1851541197 | Memorial Hospital | Clinic/Center | 509 Memorial Dr, Suite 2, Manchester, KY 40962-6195 | 2008-09-23 |
| 1154587947 | Gail Harkins | Nurse Practitioner | 509 Memorial Dr, Manchester, KY 40962-6195 | 2008-08-01 |
| 1497887921 | Memorial Hospital, Inc. | Clinic/Center | 509 Memorial Dr, Suite 2, Manchester, KY 40962-6195 | 2007-03-10 |
| 1235292764 | Joseph James | Internal Medicine | 509 Memorial Dr, Manchester, KY 40962-6195 | 2006-12-18 |
| 1053428003 | Medi Center Drugs, Inc. | Durable Medical Equipment & Medical Supplies | 509 Memorial Dr, Ste 1, Manchester, KY 40962-6195 | 2006-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609392356 | Angela Woods | Speech-Language Pathologist | 96 Woods Rd, Manchester, KY 40962 | 2017-08-15 |
| 1346627296 | Betty Alevras | Nurse Practitioner | 21 Crestview Drive, 204 Town Branch Road, Manchester, KY 40962 | 2015-04-29 |
| 1740525773 | Clay Community Pharmacy LLC | Pharmacy | 118 Clay Co S/c, Manchester, KY 40962 | 2012-12-03 |
| 1669758579 | Becky F Stubblefield | Nurse Practitioner | 65 Glenndale Drive, Manchester, KY 40962 | 2011-10-25 |
| 1891022315 | Sabrina Nicole Hacker | Occupational Therapist | 376 Manchester Square Shopping Centre, Manchester, KY 40962 | 2009-11-04 |
| 1114102167 | H&n Drug | Durable Medical Equipment & Medical Supplies | 515 Memorial Dr., Suite 2, Manchester, KY 40962 | 2008-01-08 |
| 1598944043 | Cumberland Valley Dist. Health Dept | Public Health or Welfare | 1983 Hwy 421, Manchester, KY 40962 | 2007-11-01 |
| 1023223203 | Dinah Lynn Sowders | Speech-Language Pathologist | 561 Mill Pond Drive, Manchester, KY 40962 | 2007-05-11 |
| 1104965300 | American Health Management, Inc. | Case Management | 2609 Hwy 80, Manchester, KY 40962 | 2007-02-05 |
| 1306902572 | Manchester Pharmacist Group LLC | Durable Medical Equipment & Medical Supplies | 415 Richmond Road, Unit B, Manchester, KY 40962 | 2006-12-29 |
| Find all providers in zip 40962 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356729487 | Kelsey Wood | Physician Assistant | 574 Middle Turnpike East, Kelsey Wood, Manchester, CT 06040-3730 | 2015-05-08 |
| 1841626678 | Evan Patrick Dyer | Physician Assistant | 1415 Hillsboro Blvd Ste 106, Manchester, TN 37355-2599 | 2013-09-25 |
| 1528313350 | Stephanie Elaine Fangman | Physician Assistant | 709 W Main St Ste 3, Manchester, IA 52057-1526 | 2012-07-18 |
| 1932351673 | Michael Anthony Ascenzia | Physician Assistant | 360 Tolland Tpke Ste 1a, Manchester, CT 06042-1759 | 2008-10-14 |
| 1780747519 | Wendy Brown Jorgensen | Physician Assistant | 1053 Western Avenue, Manchester, ME 04351 | 2006-12-19 |
| 1770694945 | Briana Marie Peterson | Physician Assistant | 574 E Middle Tpke, Manchester, CT 06040-3730 | 2006-08-31 |
| 1245249010 | Holly Pelletier | Physician Assistant | 57 Webster St Ste 110, Manchester, NH 03104-2552 | 2006-08-07 |
| 1558396192 | Nancy E. Kalinski | Physician Assistant | 102 Bay St, Manchester, NH 03104-3008 | 2006-07-12 |
| 1790787323 | Paul Barlow | Physician Assistant | 1 Highlander Way Ste 4, Manchester, NH 03103-7404 | 2005-08-12 |
| 1669030177 | Alexis Deitz | Physician Assistant | 574 Middle Tpke E, Manchester, CT 06040-3730 | 2019-05-30 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 40962 |
Please comment or provide details below to improve the information on MRS. CRYSTAL SMITH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.