CRYSTAL SHANTEL REYNOLDS (NPI# 1407461254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407461254 |
| Entity Type | Individual |
| Full Name | CRYSTAL SHANTEL REYNOLDS |
| Practice Address |
365 Mate Creek Road Red Jacket WV 25692 |
| Mailing Address |
Po Box 275 Red Jacket WV 25692-0275 |
| Practice Telephone | 3044264943 |
| Mailing Telephone | 3044264943 |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-09-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457748857 | Crystal Alese Reynolds | Specialist/Technologist | 1871 Montclair Dr, Unit A, Mount Pleasant, SC 29464-7544 | 2015-04-23 |
| 1679966998 | Crystal Nicole Reynolds | Occupational Therapist | 2384 Garden Hills Loop, Richmond Hill, GA 31324-6091 | 2015-03-11 |
| 1992206718 | Crystal Reynolds | Behavior Technician | 260 Peachtree St Nw Ste 2200, Atlanta, GA 30303-1292 | 2018-02-27 |
| 1962890665 | Crystal Reynolds | Registered Nurse | 424 Savannah Rd, Lewes, DE 19958-1462 | 2015-01-03 |
| Street Address |
365 MATE CREEK ROAD |
| City | RED JACKET |
| State | WV |
| Zip Code | 25692 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779382 | Flora Ann Ratliff | Technician | Route 6 Newtown, Red Jacket, WV 25692 | 2020-10-30 |
| 1093314882 | Sherry Renee Gross | Technician | 2111 Mate Creek Road, Red Jacket, WV 25692 | 2020-10-22 |
| 1982203725 | Shane Keith Dillon | Technician | Shop Hollow Route 6 Mate Creek, Red Jacket, WV 25692 | 2020-10-22 |
| 1407469661 | Carolyn F Lecco | Technician | 177 Jacob Lane, Red Jacket, WV 25692 | 2020-08-27 |
| 1740893098 | Robert Dale Kennedy | Technician | 460 Mitchell Branch, Red Jacket, WV 25692 | 2020-08-26 |
| 1396358826 | Tabitha Leann Ferguson | Technician | 158 Mitchell Branch Road, Red Jacket, WV 25692 | 2020-08-25 |
| 1174136642 | Darlene Nmn Hensley | Technician | 224 Mitchell Branch Road, Red Jacket, WV 25692 | 2020-08-25 |
| 1427661917 | Dexter Jude Jr. | Technician | 720 Mitchell Branch Road, Red Jacket, WV 25692 | 2020-08-25 |
| 1427661131 | Janice M Hammond | Technician | 4555 Mate Creek Road, Meador, WV 25692 | 2020-08-24 |
| 1518578558 | Shayla Raeann Cox | Technician | 101 Indian Ally, Apartment 20, Red Jacket, WV 25692 | 2020-08-13 |
| Find all providers in zip 25692 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779382 | Flora Ann Ratliff | Technician | Route 6 Newtown, Red Jacket, WV 25692 | 2020-10-30 |
| 1093314882 | Sherry Renee Gross | Technician | 2111 Mate Creek Road, Red Jacket, WV 25692 | 2020-10-22 |
| 1982203725 | Shane Keith Dillon | Technician | Shop Hollow Route 6 Mate Creek, Red Jacket, WV 25692 | 2020-10-22 |
| 1407469661 | Carolyn F Lecco | Technician | 177 Jacob Lane, Red Jacket, WV 25692 | 2020-08-27 |
| 1740893098 | Robert Dale Kennedy | Technician | 460 Mitchell Branch, Red Jacket, WV 25692 | 2020-08-26 |
| 1396358826 | Tabitha Leann Ferguson | Technician | 158 Mitchell Branch Road, Red Jacket, WV 25692 | 2020-08-25 |
| 1174136642 | Darlene Nmn Hensley | Technician | 224 Mitchell Branch Road, Red Jacket, WV 25692 | 2020-08-25 |
| 1427661917 | Dexter Jude Jr. | Technician | 720 Mitchell Branch Road, Red Jacket, WV 25692 | 2020-08-25 |
| 1518578558 | Shayla Raeann Cox | Technician | 101 Indian Ally, Apartment 20, Red Jacket, WV 25692 | 2020-08-13 |
| 1073123717 | Paul E Maynard | Technician | Route 6 Lot 110 Mate Creek Rd, Red Jacket, WV 25692 | 2020-08-07 |
| Find all providers in RED JACKET | ||||
| City | RED JACKET |
| Zip Code | 25692 |
Please comment or provide details below to improve the information on CRYSTAL SHANTEL REYNOLDS.
| 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.