Individual provider Active NPI

Lisa Anne Crouch, MA

  • Audiologist
  • Bluffton, SC
National Provider Identifier
1285883744
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
3996 Issued in SC
Practice address
10 William Pope Dr
Sungate Medical Center
Bluffton, SC 29909-7549
Phone
(843) 842-2020
Fax
(843) 705-1512
NPI assigned
Sep 9, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston ENT Associates, LLC 77 clinicians

Practice addresses (Care Compare)

2295 Henry Tecklenburg Dr
Charleston, SC 29414-7801
Phone (843) 766-7103

Merit-based Incentive Payment System (MIPS)

Final score
92.33 of 100Reported as group
Quality
86.06
Promoting interoperability
100
Improvement activities
40

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20140604001769 SC Practitioner - Qualified Audiologist 3678631793 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3996SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston ENT Associates, LLC CurrentSince Aug 1, 2017 Accepting new patients
Charleston ENT Associates, LLC CurrentSince Aug 1, 2017 Accepting new patients
Osler Hma Medical Group LLC Past Accepting new patients
Osler Medical Inc Past Accepting new patients

Locations

6 Arley Way
#101
Bluffton, SC 29910

2295 Henry Tecklenburg Dr
Charleston, SC 29414

1849 Savage Rd
Charleston, SC 29407
Phone (843) 576-2600

Interoperability endpoints

  • Direct secure messaging: lisa.crouch.p93@direct.tenet.nextgenshare.com

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY358 FL
Audiologist 231H00000X 3996 SC Primary

Addresses

NPPES NPI Registry

Primary practice location

10 William Pope Dr
Sungate Medical Center
Bluffton, SC 29909-7549

Mailing address

10 William Pope Dr
Sungate Medical Center
Bluffton, SC 29909-7549
Phone (843) 842-2020

Other names 1

NPPES NPI Registry
  • Lisa Anne Roberts Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 1, 2017.

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1285883744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WILLIAM POPE DR",
            "address_2": "SUNGATE MEDICAL CENTER",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299097549",
            "telephone_number": "843-842-2020",
            "fax_number": "843-705-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WILLIAM POPE DR",
            "address_2": "SUNGATE MEDICAL CENTER",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299097549",
            "telephone_number": "843-842-2020",
            "fax_number": "843-705-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY358",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "SC",
            "license": "3996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "ROBERTS",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bluffton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.