DR. CRYSTAL H BASTIN (NPI# 1962453191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962453191 |
| Entity Type | Individual |
| Full Name | DR. CRYSTAL H BASTIN |
| Other Name | CRYSTAL LEA HEATHERMAN |
| Credential | M.D. |
| Practice Address |
4820 Kentucky St South Charleston WV 25309 |
| Mailing Address |
4605 Maccorkle Ave Sw Ths Physician Partners, Inc. - Admin Ofc South Charleston WV 25309-1311 |
| Practice Telephone | 3047200390 |
| Practice Fax Number | 3047200391 |
| Mailing Telephone | 3044144800 |
| Mailing Fax Number | 3044144801 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2018-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 20368 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | GROUP MEDICARE | B441 | 01 |
| Street Address |
4820 KENTUCKY ST |
| City | SOUTH CHARLESTON |
| State | WV |
| Zip Code | 25309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053539387 | Crystal Bastin Md LLC | Family Medicine | 4820 Kentucky St, South Charleston, WV 25309-1310 | 2007-04-23 |
| 1114026671 | Rebecca J Donohoe | Nurse Practitioner | 4820 Kentucky St, South Charleston, WV 25309-1310 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376905 | Lovie Bradshaw | Technician | 4823 Tennessee St., South Charleston, WV 25309 | 2020-11-03 |
| 1306447735 | Barbara Mackenzie | Technician | 4224 Kanawha Turnpike, South Charleston, WV 25309 | 2020-11-03 |
| 1548861974 | Sarah Nichols | Technician | 4990 Colonial Park Dr. Apt. F, South Charleston, WV 25309 | 2020-11-03 |
| 1629690177 | Jennifer Mabry-goins | Technician | 4505 River Avenue, S Charleston, WV 25309 | 2020-05-07 |
| 1811537715 | Brandon C Dean | Psychologist | 4857 Macorkle Ave. Sw, South Charleston, WV 25309 | 2020-01-09 |
| 1467096057 | Linda Mullins | Technician | 60 Hayvon Lane, South Charleston, WV 25309 | 2019-11-06 |
| 1831743616 | Ann Myriah Beck | Nurse Practitioner | 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 | 2019-07-30 |
| 1942671227 | Edward W Eskew | Family Medicine | 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 | 2015-10-13 |
| 1720468218 | Link Investments LLC | Pharmacy | 5151 Macorkle Avenue, South Charleston, WV 25309 | 2015-06-01 |
| 1366840951 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 304 Southbridge Blvd., S.ccharleston, WV 25309 | 2014-12-12 |
| Find all providers in zip 25309 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003213471 | Neveah Health & Wellness Center, Pllc | Family Medicine | 538 3rd Avenue, South Charleston, WV 25303 | 2014-12-01 |
| 1376967471 | Camc Urgent Care Southridge | Family Medicine | 301 Rhl Ste 3, South Charleston, WV 25309-8275 | 2014-02-10 |
| 1578908703 | Patel Inc. | Family Medicine | 129 7th Ave, South Charleston, WV 25303-1417 | 2013-05-01 |
| 1467535450 | Patel & Patel Md Inc | Family Medicine | 401 Division St Ste 306, South Charleston, WV 25309-1455 | 2006-10-23 |
| 1073547097 | Adam J Breinig | Family Medicine | 1563 Sand Plant Rd, South Charleston, WV 25309-6120 | 2006-07-10 |
| 1598792202 | Delberta S Riffe | Family Medicine | 312 6th Ave Sw, Suite 3, South Charleston, WV 25303-1242 | 2006-06-27 |
| 1568420586 | Richard D Hayes, Jr | Family Medicine | 312 6th Ave, Suite 3, South Charleston, WV 25303-1265 | 2006-05-01 |
| 1821058348 | Paul Timothy Kuryla | Family Medicine | 400 Division St Ste 6, South Charleston, WV 25309-1459 | 2006-03-27 |
| 1730174145 | D Duane Berry | Family Medicine | 5220 Maccorkle Ave Sw, South Charleston, WV 25309-1010 | 2005-09-13 |
| 1760485593 | Michael Shane Dewitt | Family Medicine | 506 Chestnut Street, South Charleston, WV 25309-1402 | 2005-05-24 |
| Find all providers in SOUTH CHARLESTON | ||||
| City | SOUTH CHARLESTON |
| Zip Code | 25309 |
Please comment or provide details below to improve the information on DR. CRYSTAL H BASTIN.
| 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.