Chrystell Laura Cluck, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-08301 Issued in NC

Practice address

330 Billingsley Rd Ste 205
Charlotte, NC 28211-5020

Phone

(704) 333-9113

Fax

(980) 217-7243

NPI assigned

Oct 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, TN2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metrolina Dermatology and Skin Surgery Specialists PLLCGroup PAC ID 3173891892, 39 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.2 of 100Reported as group

Promoting interoperability

92

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

78.77 of 100Reported as group

Quality

85.91

Promoting interoperability

96

Improvement activities

40

Cost

46.66

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Metrolina Dermatology and Skin Surgery Specialists, PLLC

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1619400033
  Medicare reassignment Care Compare group
• Skin Solutions Dermatology & Skin Cancer Surgery, P.C.

  • Specialist
  • Franklin, TN
  • NPI 1215940366
  Medicare reassignment
• Stratum Health Collective PLLC

  • Integrative Medicine Physician
  • Brentwood, TN
  • NPI 1740121516
  NPD (past)

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1326514787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 SCOTT AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282036048",
            "telephone_number": "252-917-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BILLINGSLEY RD STE 205",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282115020",
            "telephone_number": "704-333-9113",
            "fax_number": "980-217-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUCK",
        "first_name": "CHRYSTELL",
        "middle_name": "LAURA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cloud Care Express
• Shakiya Cloud
• CLT Custom Cranial Prosthesis
• Cltspeech
• Club Success
• Molly Kasson Clune
• Candace Charley Clyburn-Gamble, LCMHC
• Kanitra Shavon Clyburn, NP
• Telisha S Clyburn
• Brittany Bergin Clyne, MD

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, 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 Oct 9, 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.