Individual provider Active NPI

Tyler Wade Crane, AGACNP-BC

  • Nurse Practitioner
  • Bermuda Run, NC
National Provider Identifier
1548711385
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5009002 Issued in NC
Practice address
329 NC Highway 801 N
Bermuda Run, NC 27006-7905
Phone
(336) 716-8200
Fax
(336) 716-9841
NPI assigned
Oct 17, 2016
Last updated
Jan 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5009002 NC Primary
Acute Care Nurse Practitioner 363LA2100X 5009002 NC
Student in an Organized Health Care Education/Training Program 390200000X 255846 NC

Addresses

Primary practice location

329 NC Highway 801 N
Bermuda Run, NC 27006-7905

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-2255

Other practice location 1

375 Hospital St Ste 200
Mocksville, NC 27028
Phone (336) 751-2121

Other practice location 2

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 277-2200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tcrane409139@direct.novanthealth.org

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
I20161228001361 NC Practitioner - Nurse Practitioner 4284915588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

329 Hwy 801 N
Bermuda Run, NC 27006
Phone (336) 716-2255

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5009002NCMDNurse Practitioner
255846NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Sep 29, 2025 Accepting new patients
Novant Health Medical Group, LLC PastSince Nov 3, 2019 Accepting new patients
Statesville Hma Medical Group, LLC PastSince Nov 3, 2019 Accepting new patients

Locations

329 NC Highway 801 N
Bermuda Run, NC 27006
Phone (336) 716-8200

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: tcrane2865731@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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 5

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1548711385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 NC HIGHWAY 801 N",
            "city": "BERMUDA RUN",
            "state": "NC",
            "postal_code": "270067905",
            "telephone_number": "336-716-8200",
            "fax_number": "336-716-9841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 Hospital St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mocksville",
            "state": "NC",
            "postal_code": "27028",
            "country_code": "US",
            "telephone_number": "336-751-2121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Silas Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033013",
            "country_code": "US",
            "telephone_number": "336-277-2200",
            "fax_number": "336-277-2210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRANE",
        "first_name": "TYLER",
        "middle_name": "WADE",
        "name_prefix": "Mr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-17",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5009002",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "5009002",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "255846",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tcrane409139@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "3333 Silas Creek Pkwy",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271033013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bermuda Run, NC

Sources for this page

Verify at the official NPI Registry.