Individual provider Active NPI

Kristen Crocker

  • Certified Registered Nurse Anesthetist
  • Charleston, SC
National Provider Identifier
1265113617
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28895 Issued in SC
Practice address
9263 Medical Plaza Dr Ste E
Charleston, SC 29406-7112
Phone
(843) 572-1228
NPI assigned
Jul 28, 2023
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28895 SC Primary
Critical Care Medicine Registered Nurse 163WC0200X RN278049 GA

Addresses

Primary practice location

9263 Medical Plaza Dr Ste E
Charleston, SC 29406-7112

Mailing address

9263 Medical Plaza Dr Ste E
Charleston, SC 29406-7112
Phone (843) 572-1228

Other practice location 1

151 Rutledge Ave
Charleston, SC 29425-8903
Phone (843) 792-3328

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240812002297 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8022556836 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trident Anesthesia Group LLCGroup PAC ID 5294631545, 121 clinicians

Practice addresses (Care Compare)

9330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (843) 797-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN278049GAMDCritical Care Medicine Registered Nurse
28895SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trident Anesthesia Group, LLC CurrentSince Jul 15, 2024 Accepting new patients
Coastal Anesthesia Associates, LLC CurrentSince Jul 15, 2024 Accepting new patients

Locations

423 Barony St
Moncks Corner, SC 29461

9263 Medical Plaza Dr
Ste E
North Charleston, SC 29406
Phone (843) 572-1228

9313 Medical Plaza Dr
Ste 102
North Charleston, SC 29406
Phone (843) 572-1228

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

130 Edge St
Summerville, SC 29486
Phone (843) 628-5816

295 Midland Pkwy
Summerville, SC 29485
Phone (843) 554-6366

Organizations & group practices 2

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": "1690502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1265113617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9263 MEDICAL PLAZA DR STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294067112",
            "telephone_number": "843-572-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9263 MEDICAL PLAZA DR STE E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294067112",
            "telephone_number": "843-572-1228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Rutledge Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258903",
            "country_code": "US",
            "telephone_number": "843-792-3328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-28",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "28895",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "GA",
            "license": "RN278049",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.