Individual provider Active NPI

Grace Crowder, PA-C

  • Medical Physician Assistant
  • Kernersville, NC
National Provider Identifier
1730992280
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1750 Kernersville Medical Pkwy
Kernersville, NC 27284-7146
Phone
(336) 564-4000
NPI assigned
Jan 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

1750 Kernersville Medical Pkwy
Kernersville, NC 27284-7146

Mailing address

205 Buckland Way
Greenville, SC 29615-6045
Phone (864) 906-3325

Other practice location 1

6915 Village Medical Cir
Clemmons, NC 27012-8002
Phone (336) 893-1000

Other practice location 2

207 Old Lexington Rd
Thomasville, NC 27360-3428
Phone (336) 472-2000

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
I20250314003577 NC Practitioner - Physician Assistant 4880116151 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

NPI Registry JSON

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1730992280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BUCKLAND WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156045",
            "telephone_number": "864-906-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 KERNERSVILLE MEDICAL PKWY",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847146",
            "telephone_number": "336-564-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6915 Village Medical Cir",
            "address_purpose": "LOCATION",
            "city": "Clemmons",
            "state": "NC",
            "postal_code": "270128002",
            "country_code": "US",
            "telephone_number": "336-893-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "207 Old Lexington Rd",
            "address_purpose": "LOCATION",
            "city": "Thomasville",
            "state": "NC",
            "postal_code": "273603428",
            "country_code": "US",
            "telephone_number": "336-472-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROWDER",
        "first_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.