CMS-1500 Box 24J / 33a • NPI
1689299919
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LP0808X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health
Box 32 Service Location & ZIP+4
208 E UNAKA AVE, JOHNSON CITY, TN, 37601-4626
✓ 9-Digit EDI 837 ZIP+4 (37601-4626)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1689299919 (CRYSTAL B ALDREDGE, MSN) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1689299919 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | CRYSTAL B ALDREDGE, MSN |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health NUCC Code: 363LP0808X (Nurse Practitioner, Psych/Mental Health) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 208 E UNAKA AVE, JOHNSON CITY, TN, 37601-4626 |
| Practice Telephone / Fax | Tel: (423) 926-0940 | Fax: (423) 926-4202 |
| Administrative Mailing Address | 1167 SPRATLIN PARK DR, GRAY, TN, 37615-6205 |
| Enumeration & Last Sync | Enumerated: 2020-06-12 | CMS Record Updated: 2026-05-22 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LP0808X)
What Does Taxonomy Code 363LP0808X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LP0808X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (CRYSTAL B ALDREDGE, MSN)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
163WP0808X — Registered Nurse, Psych/Mental HealthPlain English: Licensed & Credentialed Registered Nurse, Psych/Mental Health | State: VA | License: 0001265612 | Primary: Secondary |
363LP0808X — Nurse Practitioner, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health | State: TN | License: 27739 | Primary: Secondary |
163W00000X — Registered NursePlain English: Licensed & Credentialed Registered Nurse | State: WA | License: RN61160798 | Primary: Secondary |
363LP0808X — Nurse Practitioner, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health | State: WA | License: AP61169907 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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