Crystal Sowder Rose, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

103916 Issued in NC

Practice address

1901 S Hawthorne Rd Ste 220
Winston Salem, NC 27103

Phone

(336) 718-6777

Fax

(336) 718-6773

NPI assigned

May 25, 2006

Last updated

Jul 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: crose200867@direct.novanthealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Forsyth Memorial Hospital, Inc.

  dba NH Forsyth Primary Care Clinics

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment Care Compare group
• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group
• Forsyth Memorial Hospital Inc.

  dba Novant Health Brain and Spine Surgery

  • Neurological Surgery Physician
  • Thomasville, NC
  • NPI 1841775616
  NPD
• Forsyth Memorial Hospital, Inc.

  dba Novant Health Heart & Vascular Institute - Frontis Plaza

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1932935475
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Cancer Institute

  • Gynecologic Oncology Physician
  • Gastonia, NC
  • NPI 1093369530
  NPD
• Forsyth Memorial Hospital, Inc

  dba Novant Health Surry Medical Associates

  • Family Medicine Physician
  • Mount Airy, NC
  • NPI 1295783108
  NPD (past)
• Johnson Neurological Clinic, Inc.

  • Neurology Physician
  • High Point, NC
  • NPI 1114921954
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forsyth Memorial Hospital, Inc.

  dba Novant Health Forsyth Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1215983044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S HAWTHORNE RD STE 220",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-718-6777",
            "fax_number": "336-718-6773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1471 Jag Branch Blvd Unit 105",
            "address_purpose": "LOCATION",
            "city": "Kernersville",
            "state": "NC",
            "postal_code": "272846963",
            "country_code": "US",
            "telephone_number": "336-277-6430",
            "fax_number": "336-277-6448",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1492 Rymco Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271032944",
            "country_code": "US",
            "telephone_number": "336-765-5553",
            "fax_number": "336-765-5359",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "280 Broad St Ste A",
            "address_purpose": "LOCATION",
            "city": "Kernersville",
            "state": "NC",
            "postal_code": "27284",
            "country_code": "US",
            "telephone_number": "336-515-7060",
            "fax_number": "336-515-7069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "CRYSTAL",
        "middle_name": "SOWDER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103916",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103916",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crose200867@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1492 Rymco Dr",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271032944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crose200867@direct.novanthealth.org",
            "affiliation": "N",
            "endpointDescription": "crose200867@direct.novanthealth.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1471 Jag Branch Blvd Unit 105",
            "city": "Kernersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272846963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Elizabeth Roper, M.D.
• Kenneth Roper
• Brian Rosa, OTS
• Nancy Dominique Rosales, MD
• Maria Rosario Mejias
• Danielle Matson Rose, CRNA
• Donald R Rose Jr., MD
• Jeffrey Saxon Rose
• Jessica Savidge Rose, CRNA
• Lucy Rose, MD

• Physician Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.