Individual provider Active NPI

Kayla Crosby

  • Physician Assistant
  • Sky Valley, GA
National Provider Identifier
1639843568
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11802 Issued in NC
Practice address
443 Bald Mountain Rd
Sky Valley, GA 30537-2898
Phone
(828) 399-0021
NPI assigned
Aug 4, 2021
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-11802 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

443 Bald Mountain Rd
Sky Valley, GA 30537-2898

Mailing address

443 Bald Mountain Rd Unit 202
Sky Valley, GA 30537-2898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 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

Enrollment IDStateProvider typePAC IDDetails
I20220118000159 NC Practitioner - Physician Assistant 2264824606 Reassigns benefits to 3 organizations
I20230711000225 GA Practitioner - Physician Assistant 2264824606

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11013GAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage Services, PC Physician Assistant Past Accepting new patients

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, 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": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1639843568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 BALD MOUNTAIN RD UNIT 202",
            "city": "SKY VALLEY",
            "state": "GA",
            "postal_code": "305372898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "443 BALD MOUNTAIN RD",
            "city": "SKY VALLEY",
            "state": "GA",
            "postal_code": "305372898",
            "telephone_number": "828-399-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSBY",
        "first_name": "KAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11802",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.