Brennen Criswell

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2876 Issued in WV

Practice address

1600 Medical Center Drive
Suite 1500
Huntington, WV 25701-3657

Phone

(304) 691-1100

Fax

(304) 691-1153

NPI assigned

Jan 4, 2023

Sex

Male

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 WV

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

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Physicians and Surgeons, IncGroup PAC ID 2961315734, 379 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cabell Huntington Hospital, Inc Hospital, Huntington, WV, CCN 510055
• St Marys Medical Center Hospital, Huntington, WV, CCN 510007

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brennen.criswell@marshall.cernerdirect.com

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.

• University Physicians & Surgeons, Inc

  • Internal Medicine Physician
  • Huntington, WV
  • NPI 1730183286

  Physician Assistant

  Medicare reassignment Care Compare group NPD

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

• Cabell Huntington Hospital Inc

  • General Acute Care Hospital
  • Huntington, WV
  • NPI 1073518007
  Care Compare affiliation
• St. Mary'S Medical Center Inc

  • General Acute Care Hospital
  • Huntington, WV
  • NPI 1164492195
  Care Compare affiliation

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1699488627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 10TH AVENUE",
            "address_2": "SUITE 304",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013579",
            "telephone_number": "304-691-6381",
            "fax_number": "304-691-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DRIVE",
            "address_2": "SUITE 1500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013657",
            "telephone_number": "304-691-1100",
            "fax_number": "304-691-1153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Mingo Street",
            "address_purpose": "LOCATION",
            "city": "Kermit",
            "state": "WV",
            "postal_code": "256740430",
            "country_code": "US",
            "telephone_number": "304-393-4303",
            "fax_number": "304-393-3254",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "67 Hereford Lane",
            "address_purpose": "LOCATION",
            "city": "Apple Grove",
            "state": "WV",
            "postal_code": "255029403",
            "country_code": "US",
            "telephone_number": "304-733-8750",
            "fax_number": "304-733-6042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "659 Central Avenue",
            "address_purpose": "LOCATION",
            "city": "Barboursville",
            "state": "WV",
            "postal_code": "255041313",
            "country_code": "US",
            "telephone_number": "304-736-5247",
            "fax_number": "304-736-7367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4600 Route 152",
            "address_purpose": "LOCATION",
            "city": "Lavalette",
            "state": "WV",
            "postal_code": "255359702",
            "country_code": "US",
            "telephone_number": "304-697-9480",
            "fax_number": "304-697-9491",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Cabell Huntington Hospital 1340 Hal Greer Blvd",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "25701",
            "country_code": "US",
            "telephone_number": "304-526-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3952 Teays Valley Road",
            "address_purpose": "LOCATION",
            "city": "Hurricane",
            "state": "WV",
            "postal_code": "255268728",
            "country_code": "US",
            "telephone_number": "304-757-6736",
            "fax_number": "304-757-0582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRISWELL",
        "first_name": "BRENNEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-04",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "2876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brennen.criswell@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1600 Medical Center Drive",
            "address_2": "Suite 1500",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lorrie Lea Crigger
• Amber Crisp
• Kaylee Crisp
• Stacy Rolonda Crisp
• Alyce Crist
• Kayla Criswell
• Myleaha Crocket
• Charity Crockett
• G Roland Crockett, DDS
• John David Crompton, M.D.

• Physician Assistant in Huntington, WV
• Providers in Huntington, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.