Crystal D Campbell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-02524 Issued in NC

Practice address

3815 Faber Place Dr
North Charleston, SC 29405-8533

Phone

(843) 767-9312

Fax

(843) 767-9313

NPI assigned

May 25, 2010

Last updated

Jan 11, 2022By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Physician Assistant

Education

University of South Carolina School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Carolina Multispecialty Associates LLCGroup PAC ID 9931105046, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trident Medical Center Hospital, Charleston, SC, CCN 420079
• Colleton Medical Center Hospital, Walterboro, SC, CCN 420030

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: crystal.campbell@hca5.eclinicaldirectplus.com
• Direct secure messaging: trident.coctr.sca@ccda.hcadirect.net

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.

• Coastal Carolina Multispecialty Associates, LLC

  dba Coastal Carolina Surgical Specialists

  • Specialist
  • Summerville, SC
  • NPI 1518079102
  Medicare reassignment Care Compare group
• Intensive Care Consortium Inc

  • Specialist
  • Aventura, FL
  • NPI 1629019062

  SC

  Medicare reassignment
• Coastal Carolina Multispecialty Assocs, LLC

  • Specialist
  • North Charleston, SC
  • NPI 1184730749
  NPD (past)
• Poseidon Inpatient Services, LLC

  • Hospitalist Physician
  • Charleston, SC
  • NPI 1609214378
  NPD (past)
• Wake Nephrology Associates, P.a.

  • Specialist
  • Raleigh, NC
  • NPI 1891797049
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Trident Medical Center, LLC

  dba HCA Healthcare Trident Hospital

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1366496937
  Care Compare affiliation
• Walterboro Community Hospital, Inc.

  dba HCA Healthcare Colleton Hospital

  • General Acute Care Hospital
  • Walterboro, SC
  • NPI 1376597997
  Care Compare affiliation

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1447579727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 FABER STREET",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294057511",
            "telephone_number": "843-767-9312",
            "fax_number": "843-767-9313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 FABER PLACE DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294058533",
            "telephone_number": "843-767-9312",
            "fax_number": "843-767-9313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CRYSTAL",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-25",
        "last_updated": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TRIDENT.COCTR.SCA@CCDA.HCADIRECT.NET",
            "affiliation": "N",
            "address_1": "3815 Faber Place Dr",
            "city": "North Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294058533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eric Caloud, ATC
• Wendy Abigale Camacho, LPCA
• Ronald Cameron
• James Scott Camp, RPH
• Meagan Camp
• Ian Campbell, DPT
• James D Campbell
• Kathryn Player Campbell, LPCA
• Kevin William Campbell, PH.D.
• Kimberly Monique Campbell, LICENSED BRAIDER

• Physician Assistant in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.