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Crystal Deer-Walker , LPN

Licensed Practical Nurse β€’ Mccomb, MS

Active NPI 1225629264 Individual Practitioner Female Practitioner
Practice location in NPPES

114 S 4th St
Mccomb, MS 396484005

Call 7692043488 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

114 S 4th St

Mccomb, MS 396484005

Telephone 7692043488
Organization at the Same NPPES Address or Phone
Divine Walk In Home Care Facility NPI 1093306912

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Mccomb and Mississippi

3 active clinicians are listed under Licensed Practical Nurse with a practice address in Mccomb, MS (255 in Mississippi).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-12-14
Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

License # reported to NPPES MS 336930

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Mississippi State Medical Licensing Board.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location December 14, 2022

Registered at 114 S 4TH ST, MCCOMB, MS 396484005 (Tel: 7692043488)

πŸ“
Updated Business Mailing Address December 14, 2022

Registered at 114 S 4TH ST, MCCOMB, MS 396484005 (Tel: 6019960455)

βœ…
NPI Profile Active February 02, 2021

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) February 02, 2021

Registered at 124 N BROADWAY ST, MCCOMB, MS 396483914 (Tel: 7692043488)

πŸ“
Business Mailing Address (Initial Record) February 02, 2021

Registered at PO BOX 1033, MCCOMB, MS 396491033 (Tel: 6019960455)

πŸ‘€
Provider Name / Credentials (Initial Record) February 02, 2021

Recorded as CRYSTAL DEER-WALKER, LPN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 02, 2021

Licensed Practical Nurse (license number reported to NPPES: MS 336930)

🟒
Initial NPI Registration & Enumeration February 02, 2021

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1225629264
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 02, 2021
Last Update: December 14, 2022
Sole Proprietor: Yes

Mailing Address

114 S 4th St

Mccomb, MS 396484005

Phone: 6019960455

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.