Individual provider Active NPI

Crystal Caldwell Barksdale, PA

  • Physician Assistant
  • Salem, VA
National Provider Identifier
1255305785
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006501 Issued in VA
Practice address
1930 Braeburn Cir
Salem, VA 24153-7388
Phone
(450) 444-8100
NPI assigned
Feb 13, 2006
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110006501 VA Primary

Addresses

Primary practice location

1930 Braeburn Cir
Salem, VA 24153-7388

Mailing address

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

Other practice location 1

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

Other identifiers 1

IdentifierTypeStateIssuer
004945263MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20190405001706 VA Practitioner - Physician Assistant 4981945672 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lewis Gale Physicians LLCGroup PAC ID 6507886231, 191 clinicians

Practice addresses (Care Compare)

1802 Braeburn Dr
Salem, VA 24153-7357

1900 Electric Rd
Salem, VA 24153-7474

1902 Braeburn Dr
Salem, VA 24153-7304
Phone (540) 772-2801

1906 Braeburn Dr
Salem, VA 24153-7304
Phone (540) 772-3482

1914 Braeburn Dr
Salem, VA 24153-7304
Phone (540) 776-1018

1930 Braeburn Cir
Salem, VA 24153-7388
Phone (540) 772-3707

1940 Braeburn Cir a
Salem, VA 24153-7388
Phone (540) 724-9771

1942 Braeburn Cir
Salem, VA 24153-7388
Phone (540) 444-1240

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110006501VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Mar 4, 2019 Accepting new patients
Carilion Medical Center CurrentSince Mar 4, 2019 Accepting new patients

Locations

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

1802 Braeburn Dr
Salem, VA 24153
Phone (540) 772-3400

Interoperability endpoints

  • Direct secure messaging: crystal.barksdale@hca6.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1255305785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 BRAEBURN CIR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537388",
            "telephone_number": "450-444-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1906 Belleview Ave SE",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240141838",
            "country_code": "US",
            "telephone_number": "540-981-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARKSDALE",
        "first_name": "CRYSTAL",
        "middle_name": "CALDWELL",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945263",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.