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CRYSTAL LYNE CARRADINE DO
NPI 1659016186
Military Health Care Provider in Portsmouth, VA

Active since April 29, 2022PECOS Enrolled
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708(757) 953-5000 Get Directions Write a Review

NPPES record last updated: December 15, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 15, 2022, Apr 29, 2022 (2 updates tracked since 2022).

About Crystal Lyne Carradine Do NPPES

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

CRYSTAL LYNE CARRADINE DO (NPI 1659016186) is an individual military health care provider provider in Portsmouth, Virginia and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1659016186
Entity TypeIndividualFemale
Primary Taxonomy171000000X
Provider Legal NameCRYSTAL LYNE CARRADINECredential: DO
Location Address620 JOHN PAUL JONES CIRPortsmouth, VA 23708-2111
Mailing Address6341 Klines DrGirard, OH 44420-1260 · (330) 509-1608
Phone(757) 953-5000
Sole ProprietorYes
Enumeration DateApril 29, 2022
Last NPPES UpdateDecember 15, 20222 updates tracked since enumeration
NPPES CertifiedOctober 5, 2022
✔ NPI 1659016186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMilitary Health Care ProviderOther Service Providers
Taxonomy Code171000000X
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
620 JOHN PAUL JONES CIR, Portsmouth, VA 23708
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Crystal Lyne Carradine Do 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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEREDITH TVERDOSI CRNA
Nurse Anesthetist, Certified Registered
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-3238
ERIC FRANCIS SULAVA
Emergency Medicine
620 JOHN PAUL JONES CIR, NAVAL MEDICAL CENTER PORTSMOUTH
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-0669
MRS. TIFFNY KUPER RHH
Dental Hygienist
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-2711
DR. LAKEISHA GOODE PHARMD
Pharmacist
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-7462
JASMINE WOOD MD
Surgery
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-1895
NICHOLAS FANSELOW
General Practice
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-0669
DR. DAVID JESSEN MD
Military Health Care Provider
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-2518
MRS. WILLAR MAE BAUM L.C.S.W.
Social Worker (Clinical)
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708
Portsmouth City (757) 953-9767

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 Carradine's NPI number?

The NPI number for Crystal Carradine is 1659016186. It was assigned to this individual provider in the NPPES registry on April 29, 2022.

Where is Crystal Carradine located?

Crystal Carradine practices at 620 John Paul Jones Cir, Portsmouth, VA 23708. The listed phone number is (757) 953-5000.

What is Crystal Carradine's specialty?

The primary specialty registered for this NPI is Military Health Care Provider with taxonomy code 171000000X.

Is Crystal Carradine enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Crystal Carradine was last updated on December 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.