CRYSTAL MANN-ELLIS (NP) – Family Nurse Practitioner, NPI 1124567581

CRYSTAL MANN-ELLIS (NP) is a healthcare provider. based in Henrico, Virginia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 0024174547 (VA). The NPI Number for CRYSTAL MANN-ELLIS (NP) is 1124567581

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
CRYSTAL MANN-ELLIS (NP)
NPI
1124567581
Phone
(804) 210-3101
Address
1504 SANTA ROSA RD RM 114
Enumeration Date
18 February 2017
Last Update Date
20 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8042103103
Graduation Year
2016 (10 years ago)
PAC ID
9638455157
Group Practice PAC ID
4587030804
Professional Enrollment ID
I20170418002543
Address ID
VA232295109HE1504XRDXX402
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

8,303 NURSE PRACTITIONER in VA

Provider Addresses for CRYSTAL MANN-ELLIS (NP)

  • 1504 SANTA ROSA RD RM 114

    HENRICO, VA 232295109

    Phone: (804) 210-3101

    Type: Mailing

  • 12000 OLD BAILEY BRIDGE RD

    MIDLOTHIAN, VA 231123120

    Phone: (804) 356-1191

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 11 Open Payments records for all available years, with a total value of $314.

Total Amount is formed as General ($314) + Research ($0) + Ownership ($0) = $314.

Last reported payment date: 2024-05-02 • Largest payer in this snapshot: Ardelyx, Inc. ($173).

Total Amount

$314

General + Research + Ownership

Payments

11

Total payment records

General Amount

$314

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-02

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2017-04-18

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
I20170418002543INurse PractitionerVATBD

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 23229)

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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: 4587030804View full group profile
NameSpecialtyState
Nurse PractitionerVA
Nurse PractitionerFL
Nurse PractitionerVA
Physician AssistantTX
Nurse PractitionerVA
Nurse PractitionerVA
Internal Medicine, Geriatric MedicineGA
Physician AssistantVA
Nurse PractitionerMD
Physician AssistantVA

Reviews

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Frequently asked questions

What federal number belongs to CRYSTAL MANN-ELLIS (NP)?
The federal identifier for CRYSTAL MANN-ELLIS (NP) is NPI 1124567581.
Is CRYSTAL MANN-ELLIS (NP) active in the national directory?
CRYSTAL MANN-ELLIS (NP)'s public NPI profile is in an active state.
What does CRYSTAL MANN-ELLIS (NP) treat or focus on?
Patients typically see CRYSTAL MANN-ELLIS (NP) under the specialty Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for CRYSTAL MANN-ELLIS (NP)?
The page summarizes Henrico, Virginia for CRYSTAL MANN-ELLIS (NP); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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