Provider Demographics
NPI:1306149182
Name:SIMS, CRYSTAL LYNN (DPT, OCS)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:LYNN
Last Name:SIMS
Suffix:
Gender:F
Credentials:DPT, OCS
Other - Prefix:DR
Other - First Name:CRYSTAL
Other - Middle Name:LYNN
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:123 WALKING TRAIL WAY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-4819
Mailing Address - Country:US
Mailing Address - Phone:703-362-4193
Mailing Address - Fax:
Practice Address - Street 1:97 HUGHES RD STE P
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3401
Practice Address - Country:US
Practice Address - Phone:256-774-2978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-16
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1189678225100000X
ALPTH9681225100000X
TX100193492251X0800X
MD212616225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1292876510Medicaid
AL1306149182Medicaid