Crystal Edwards, P.A.-C
Individual provider Active NPI Physician Assistant · Bladenboro, NC
NPI 1992795041 · NPPES record last updated Jun 13, 2024
Key facts
- NPI
- 1992795041
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 103768 (NC)
- Practice address
- 125 S Main St Ste a
Bladenboro, NC 28320-8440 - Phone
- (910) 809-0030
- NPI assigned
- Oct 28, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Brody School of Medicine at East Carolina University, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Skin and Wellness Center PLLC
Practice addresses (Care Compare)
125 S Main St
Suite a
Bladenboro, NC 28320-8440
Phone (910) 809-0030
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111123000235 | NC | Practitioner - Physician Assistant | 0345414637 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103768 | NC | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | |||
| Physician Assistant | 363A00000X | 103768 | NC | Yes |
Addresses
Primary practice location
125 S Main St Ste a
Bladenboro, NC 28320-8440
Mailing address
PO Box 88
Bladenboro, NC 28320-0088
Phone (910) 809-0030
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8941520 | Medicaid | NC | |
| 02703 | Other | NC | BCBS |
Other providers in Bladenboro, NC
- Tiffany Anne Clowers
- Coastal Southeastern United Care LLC
- Donald Benton Helms
- Michal Paul Dove
- Dr. Kim'S Adult Clinic, PLLC
- Allison Cavenaugh Eggleston
- Family Alternatives, Inc
- Fuller & Associates VI PLLC
- Gate Way Health Care Associates LLC
- Gate Way Health Care Associates LLC
All providers in Bladenboro, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.