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Crystal Bastin MD LLC

Family Medicine Physician in South Charleston, WV · enumerated 2007 · authorized official Shannon Davis, Office Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1053539387

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Registry record

Entity type Organization (Type 2)
Legal business name Crystal Bastin MD LLC
Practice address 4820 Kentucky St, South Charleston, WV, 25309
Phone (304) 720-0390
Enumeration date Apr 23, 2007
Last updated in NPPES Nov 12, 2013

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License 20368 (WV) Primary

Authorized official

Name Shannon Davis
Title Office Manager
Phone (304) 720-0390

Other identifiers

Identifier Type State Issuer
1801865001 Medicaid WV -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Crystal Bastin MD LLC?
NPPES lists Shannon Davis (Office Manager) as the authorized official for this organization.
What is the NPI number for Crystal Bastin MD LLC?
The NPI for Crystal Bastin MD LLC is 1053539387, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2013-11-12.