CRYSTAL SOUTH (NPI# 1548446065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548446065 |
| Entity Type | Individual |
| Full Name | CRYSTAL SOUTH |
| Credential | R.N. |
| Practice Address |
1213 Maria Ln Iuka MS 38852-1135 |
| Mailing Address |
Po Box 839 Corinth MS 38835-0839 |
| Practice Telephone | 6624233332 |
| Practice Fax Number | 6622868095 |
| Mailing Telephone | 6622862152 |
| Mailing Fax Number | 6622868095 |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2008-01-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
R864058 | MS | Nursing Service Providers |
| Street Address |
1213 MARIA LN |
| City | IUKA |
| State | MS |
| Zip Code | 38852-1135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275753907 | Kathy Putman | Counselor | 1213 Maria Ln, Iuka, MS 38852-1135 | 2007-04-26 |
| 1275173122 | Taylor Graves | Case Manager/Care Coordinator | 1213 Maria Ln, Iuka, MS 38852-1135 | 2020-01-08 |
| 1255988507 | Morgan Franklin | Case Manager/Care Coordinator | 1213 Maria Ln, Iuka, MS 38852-1135 | 2019-08-21 |
| 1982175402 | Jennifer Farris | Social Worker | 1213 Maria Ln, Iuka, MS 38852-1135 | 2018-12-10 |
| 1669943130 | Kady L Cooley | Social Worker | 1213 Maria Ln, Iuka, MS 38852-1135 | 2018-12-10 |
| 1215430343 | Callee Johnson | Social Worker | 1213 Maria Ln, Iuka, MS 38852-1135 | 2018-03-15 |
| 1225541626 | Brian Keith Smith | Marriage & Family Therapist | 1213 Maria Ln, Iuka, MS 38852-1135 | 2017-11-08 |
| 1912422213 | Kayla Nicole Felker | Counselor | 1213 Maria Ln, Iuka, MS 38852-1135 | 2017-08-08 |
| 1477078939 | Tanechi Temple | Community/Behavioral Health | 1213 Maria Ln, Iuka, MS 38852-1135 | 2017-08-07 |
| 1306392725 | Natalie Mallard | Social Worker | 1213 Maria Ln, Iuka, MS 38852-1135 | 2016-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346850278 | Amy Melissa Selmon | Registered Nurse | 904 North Pearl Street, Iuka, MS 38852 | 2020-08-05 |
| 1619346475 | Michelle Johnson | Social Worker | 1223 Maria Ln, Iuka, MS 38852 | 2015-09-22 |
| 1538580386 | Mary Beth Sheffield | Dietitian, Registered | 179 Cr 995, Iuka, MS 38852 | 2013-12-20 |
| 1467887190 | Region Iv Mental Health Services Beacon House | Community/Behavioral Health | 2040 Paul Edmondson Drive, Iuka, MS 38852 | 2013-09-12 |
| 1801018106 | Preferred Care Rehab | Occupational Therapist | 502 Battleground Drive, Iuka, MS 38852 | 2007-05-03 |
| 1770706863 | Felix Morris M.d., LLC | Internal Medicine | 1777 Curtis Drive, Iuka, MS 38852 | 2007-04-10 |
| 1235272790 | Jocelyn B Doran | Dentist | 238 Kaki Street, Iuka, MS 38852 | 2007-02-15 |
| 1902953631 | Jimmy Ray Sanchez II | Chiropractor | 2009 Constitution Dr, Iuka, MS 38852 | 2007-01-04 |
| 1952476707 | Family Home Care, Inc. | Durable Medical Equipment & Medical Supplies | 1105 Battleground Drive, Iuka, MS 38852 | 2006-11-21 |
| 1669481875 | Barnett Apothecary, LLC | Pharmacist | 606 Battleground Dr, Iuka, MS 38852 | 2006-08-05 |
| Find all providers in zip 38852 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558547190 | Dana Gresham | Registered Nurse | 1213 Maria Ln, Iuka, MS 38852-1135 | 2008-01-14 |
| 1841476421 | Jana Moore | Registered Nurse | 1213 Maria Ln, Iuka, MS 38852-1135 | 2008-01-14 |
| 1831375328 | Chasity Peden | Registered Nurse | 1213 Maria Ln, Iuka, MS 38852-1135 | 2008-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043734049 | Creative Solutions Counseling Services Pllc | Registered Nurse | 902 14th St Ste B, Meridian, MS 39301-4455 | 2017-08-01 |
| 1275073157 | Martha Phillips Catlette | Registered Nurse | 64 Pratt Place Rd, Inverness, MS 38753-9574 | 2017-02-27 |
| 1558770784 | Tylinda Cotton | Registered Nurse | 91180 Hwy 42 West, Richton, MS 39476 | 2014-08-13 |
| 1508042722 | Mary Dean Stone | Registered Nurse | 2100 East Chamberss, Booneville, MS 38829 | 2008-01-17 |
| 1144406430 | Amy Cole | Registered Nurse | 2100 East Chambers, Booneville, MS 38829 | 2008-01-16 |
| 1689791105 | Cheri Delilah Ann Beck | Registered Nurse | 804 Road 1349, Mooreville, MS 38857-7325 | 2007-03-22 |
| 1114533288 | Lasontiga Forrest | Registered Nurse | 1701 White St, Mccomb, MS 39648-2711 | 2020-09-23 |
| 1063028512 | Bobbi Jo Beck | Registered Nurse | 101 Highway 7 S, Greenwood, MS 38930-6055 | 2020-09-21 |
| 1811502024 | Wendy Hopkins | Registered Nurse | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-09-14 |
| 1790393072 | Melba Richardson | Registered Nurse | 330b Highway 90, Gautier, MS 39553-5744 | 2020-07-22 |
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| 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.