Crystal Danielle Poole, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

TL1351 Issued in SC

Practice address

3815 Faber Place Dr
North Charleston, SC 29405-8533

Phone

(843) 767-9312

Fax

(843) 767-9313

NPI assigned

Sep 22, 2008

Last updated

May 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Medical University of South Carolina College of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charleston Nephrology Associates, LLCGroup PAC ID 9638138209, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: crystalwhite@cnallc.allscriptsdirect.net

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.

• Charleston Nephrology Associates, LLC

  • Nephrology Physician
  • North Charleston, SC
  • NPI 1629054960
  Medicare reassignment Care Compare group

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

• Bon Secours St. Francis Xavier Hospital Inc.

  dba Roper St. Francis Intensivist Services

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1851361778
  Care Compare affiliation
• Roper Hospital, Inc

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1962472860
  Care Compare affiliation

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1881844363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 FABER PLACE DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294058533",
            "telephone_number": "843-767-9312",
            "fax_number": "843-767-9313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 FABER PLACE DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294058533",
            "telephone_number": "843-767-9312",
            "fax_number": "843-767-9313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "CRYSTAL",
        "middle_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-22",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1351",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "TL1351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antawn Maurice Polite, LPC
• Thomalind Martin Polite, MA, CCC-SLP
• Rylee Polverelli
• Gloria Ann Pombo, PA-C
• Patricia Ann Pomeroy, LISW-CP, ACSW, BCD
• Shannon Pop, PA
• Port City Plastic Surgery, LLC
• Patricia Porter, APRN
• Positive Feedback Professional Counseling Associates
• Positive Solutions Counseling Services

• Medical Physician Assistant in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.