Individual provider Active NPI

Courtney Boyde Cribbs, PA-C

  • Surgical Physician Assistant
  • Mt Pleasant, SC
National Provider Identifier
1689768335
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1880 Issued in SC
Practice address
3510 N Highway 17 Ste 105
Mt Pleasant, SC 29466-8228
Phone
(843) 789-1850
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50.002498 OH
Surgical Physician Assistant 363AS0400X 1880 SC Primary

Addresses

Primary practice location

3510 N Highway 17 Ste 105
Mt Pleasant, SC 29466-8228

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (888) 472-0043

Other identifiers 1

IdentifierTypeStateIssuer
1593PAMedicaidSC

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130427000152 SC Practitioner - Physician Assistant 3577560556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roper Saint Francis Physicians NetworkGroup PAC ID 5193874824, 530 clinicians

Practice addresses (Care Compare)

2075 Eagle Landing Blvd
N Charleston, SC 29406-4074
Phone (843) 789-1800

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 723-6426

3500 N Hwy 17
Mt Pleasant, SC 29466-9123
Phone (843) 723-6426

3510 Hwy 17 Byp N
Suite 110
Mt Pleasant, SC 29466-8228
Phone (843) 884-8045

3510 Hwy 17 N
Suite 110
Charleston, SC 29466-8228
Phone (843) 723-2838

3510 N Hwy 17
Mt Pleasant, SC 29466-8228

3510N Hwy 17 110
Mount Pleasant, SC 29466-8228
Phone (843) 606-7246

Hospital & facility affiliations

  • Mount Pleasant Hospital Hospital, Mount Pleasant, SC, CCN 420104
  • Roper Hospital Hospital, Charleston, SC, CCN 420087
  • Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1880SCMDDental Hygienist
50.002498OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Roper St. Francis Specialty Physicians CurrentSince Feb 1, 2026 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Feb 3, 2013 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Feb 3, 2013 Accepting new patients
Roper Saint Francis Physicians Network Past Accepting new patients

Locations

1711 Clements Ferry Rd
Unit 112
Charleston, SC 29492
Phone (843) 606-7893

125 Doughty St
Ste 680
Charleston, SC 29403
Phone (843) 577-6015

2097 Henry Tecklenburg Dr
Ste 211W
Charleston, SC 29414
Phone (843) 958-2555

8536 Palmetto Commerce Pkwy
Ste 401
Ladson, SC 29456
Phone (843) 203-2260

3510 N Highway 17
Ste 105
Mt Pleasant, SC 29466
Phone (843) 789-1850

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Interoperability endpoints

  • Direct secure messaging: ccribbs1236485@direct.bsmhealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1689768335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "888-472-0043",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 N HIGHWAY 17 STE 105",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294668228",
            "telephone_number": "843-789-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIBBS",
        "first_name": "COURTNEY",
        "middle_name": "BOYDE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.002498",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "1880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1593PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

Verify at the official NPI Registry.