Individual provider Active NPI

Kelly V Crawford, APRN

  • Family Nurse Practitioner
  • Greenwood, SC
National Provider Identifier
1225558588
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21100 Issued in SC
Practice address
103 Liner Dr
Greenwood, SC 29646-2311
Phone
(864) 227-3636
Fax
(864) 227-6116
NPI assigned
Jun 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21100 SC Primary

Addresses

Primary practice location

103 Liner Dr
Greenwood, SC 29646-2311

Mailing address

103 Liner Dr
Greenwood, SC 29646-2311
Phone (864) 227-3636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20170918002278 SC Practitioner - Nurse Practitioner 9032483847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical University of South Carolina College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Disease Group PAGroup PAC ID 6002887361, 15 clinicians

Practice addresses (Care Compare)

103 Liner Dr
Greenwood, SC 29646-2311
Phone 86422736362222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Disease Group PA CurrentSince Aug 1, 2017 Accepting new patients

Locations

103 Liner Dr
Greenwood, SC 29646
Phone (864) 227-3636

Organizations & group practices 1

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

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1225558588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 LINER DR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462311",
            "telephone_number": "864-227-3636",
            "fax_number": "864-227-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 LINER DR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462311",
            "telephone_number": "864-227-3636",
            "fax_number": "864-227-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "KELLY",
        "middle_name": "V",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2022-07-21",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "21100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.