Crystal Edwards, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

103768 Issued in NC

Practice address

125 S Main St Ste a
Bladenboro, NC 28320-8440

Phone

(910) 809-0030

NPI assigned

Oct 28, 2005

Last updated

Jun 13, 2024By 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 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

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 PLLCGroup PAC ID 9638618978, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• The Skin & Wellness Center PLLC

  • Physician Assistant
  • Bladenboro, NC
  • NPI 1104668219
  Medicare reassignment Care Compare group Authorized official
• Above & Beyond Wellness and Medspa, PLLC

  • Dermatology Physician
  • Elizabethtown, NC
  • NPI 1235886870
  Medicare reassignment

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1992795041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88",
            "city": "BLADENBORO",
            "state": "NC",
            "postal_code": "283200088",
            "telephone_number": "910-809-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S MAIN ST STE A",
            "city": "BLADENBORO",
            "state": "NC",
            "postal_code": "283208440",
            "telephone_number": "910-809-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CRYSTAL",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Anne Clowers, PA-C
• Coastal Southeastern United Care LLC
• Donald Benton Helms (Bladenboro Eye Clinic)
• Michal Paul Dove
• Dr. Kim's Adult Clinic, PLLC
• Allison Cavenaugh Eggleston, D.D.S., M.S.
• Family Alternatives, Inc (Millbranch Group Home)
• Fuller & Associates VI PLLC
• Gate Way Health Care Associates LLC
• Gate Way Health Care Associates LLC

• Physician Assistant in Bladenboro, NC
• Providers in Bladenboro, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.