CRYSTAL TERESA WALL FNP
NPI 1093296022
Nurse Practitioner - Family in Charlotte, NC

Q: What is Crystal Wall's NPI number?

The NPI number for Crystal Wall is 1093296022. It was assigned to this individual provider in the NPPES registry on August 27, 2018.

Q: What is Crystal Wall's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Crystal Wall was last updated on November 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 27, 2018PECOS Enrolled

515 SAWYERS MILL RD APT 105, CHARLOTTE, NC 28262(704) 724-7697 Get Directions Write a Review

NPPES record last updated: November 26, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 26, 2019, Sep 20, 2019, Oct 2, 2018 and 2 more (5 updates tracked since 2018).

On this page

About Crystal Teresa Wall Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL TERESA WALL FNP (NPI 1093296022) is an individual family provider in Charlotte, North Carolina, licensed in North Carolina (5010941) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093296022

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameCRYSTAL TERESA WALLCredential: FNP

Location Address515 SAWYERS MILL RD APT 105Charlotte, NC 28262-1893

Mailing Address515 Sawyers Mill Rd Apt 105Charlotte, NC 28262-1893

Phone(704) 724-7697

Sole ProprietorNo

Enumeration DateAugust 27, 2018

Last NPPES UpdateNovember 26, 20195 updates tracked since enumeration

✔ NPI 1093296022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NC · 5010941

515 SAWYERS MILL RD APT 105, Charlotte, NC 28262

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Crystal Teresa Wall Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Crystal Wall reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Signify Health Medical Associates, PLLC

939 mi

General Practice

4055 VALLEY VIEW LN STE 700
Dallas, TX 75244

Reassigned Medicare billing, North Carolina enrollment
728 clinicians in this Medicare group

NPI 1750845863 (972) 715-3800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28262 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal Wall's NPI number?

The NPI number for Crystal Wall is 1093296022. It was assigned to this individual provider in the NPPES registry on August 27, 2018.

Where is Crystal Wall located?

Crystal Wall practices at 515 Sawyers Mill Rd Apt 105, Charlotte, NC 28262. The listed phone number is (704) 724-7697.

What is Crystal Wall's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Crystal Wall enrolled in Medicare?

Yes. Crystal Wall is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Crystal Wall's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Crystal Wall reassigns Medicare benefits to Signify Health Medical Associates, PLLC (Dallas, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Crystal Wall's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Crystal Wall was last updated on November 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.