CRYSTAL CHRISTOPHER – Psychiatric/Mental Health Nurse Practitioner, NPI 1093547507

CRYSTAL CHRISTOPHER is a healthcare provider. based in Jacksonville, Texas. specializing in NURSE PRACTITIONER. They hold a License No. 1203064 (TX). The NPI Number for CRYSTAL CHRISTOPHER is 1093547507

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
CRYSTAL CHRISTOPHER
NPI
1093547507
Phone
(430) 808-0508
Address
1517 E RUSK ST
Enumeration Date
14 August 2024
Last Update Date
30 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4696078778
Graduation Year
2024 (2 years ago)
PAC ID
3870004005
Group Practice PAC ID
0749679702
Professional Enrollment ID
I20250616001541
Address ID
TX752373459DA3443XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for CRYSTAL CHRISTOPHER

  • 1517 E RUSK ST

    JACKSONVILLE, TX 757665505

    Phone: (430) 808-0508

    Fax: (430) 808-0509

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-06-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250616001541INurse PractitionerTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75766)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749679702View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerNY
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

What identifier follows CRYSTAL CHRISTOPHER across health systems?
The NPI 1093547507 uniquely identifies CRYSTAL CHRISTOPHER in U.S. healthcare data.
Does the public listing show CRYSTAL CHRISTOPHER as active?
CRYSTAL CHRISTOPHER's NPI record reflects an active status in NPPES.
What type of care does CRYSTAL CHRISTOPHER provide?
CRYSTAL CHRISTOPHER's profile centers on Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Which community is linked to CRYSTAL CHRISTOPHER?
CRYSTAL CHRISTOPHER shows a connection to Jacksonville, Texas in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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