Individual provider Active NPI

Laura Jean Crumpler, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1386651826
Registry record updated Feb 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102557 Issued in NC
Practice address
3101 Latrobe Dr
Charlotte, NC 28211-4849
Phone
(704) 376-7362
NPI assigned
Aug 1, 2006
Last updated
Feb 25, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2010

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 102557 NC Primary

Addresses

Primary practice location

3101 Latrobe Dr
Charlotte, NC 28211-4849

Mailing address

3101 Latrobe Dr
Charlotte, NC 28211-4849
Phone (704) 376-7362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20050706000919 NC Practitioner - Physician Assistant 8022054519 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
98.67
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.15 of 100Reported as group
Quality
81.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102557NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Iredell County, PLLC Past Accepting new patients
Ballantyne Emergency Physicians PLLC Past Accepting new patients
Internal Medicine Specialist, PA Past Accepting new patients
Iredell Memorial Hospital, Incorporated Past Accepting new patients
Piedmont Emergency Medical Associates, PA Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267056000000",
    "number": "1386651826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 LATROBE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114849",
            "telephone_number": "704-376-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 LATROBE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114849",
            "telephone_number": "704-376-7362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMPLER",
        "first_name": "LAURA",
        "middle_name": "JEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2010-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.