CRYSTAL COAST PAIN MANAGEMENT CENTER, PLLC
NPI 1013401561
Anesthesiology - Pain Medicine in Jacksonville, NC

Q: What is Crystal Coast Pain Management Center, PLLC's specialty?

The primary specialty registered for this NPI is Anesthesiology, specializing in Pain Medicine, with taxonomy code 207LP2900X.

Active since June 19, 2018CLIA 34D2084239 · Waiver

57 OFFICE PARK DR, JACKSONVILLE, NC 28546(252) 636-0300 Get Directions Write a Review

NPPES record last updated: October 26, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 26, 2020, Jul 25, 2018, Jun 19, 2018 (3 updates tracked since 2018).

On this page

About Crystal Coast Pain Management Center, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL COAST PAIN MANAGEMENT CENTER, PLLC (NPI 1013401561) is a healthcare organization registered as a pain medicine in Jacksonville, North Carolina and active in the NPI registry since June 2018. The organization holds a CLIA Waiver certificate valid through September 21, 2026 and lists Rachel Look, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1013401561

Entity TypeOrganization

Primary Taxonomy207LP2900X

Legal Business NameCRYSTAL COAST PAIN MANAGEMENT CENTER, PLLC

Location Address57 OFFICE PARK DRJacksonville, NC 28546

Mailing Address2111 Neuse Blvd Ste JNew Bern, NC 28560-4318 · (125) 263-6030

Phone(252) 636-0300

Organization SubpartNo

Authorized OfficialRachel LookPractice Manager · (252) 636-0300

Enumeration DateJune 19, 2018

Last NPPES UpdateOctober 26, 20203 updates tracked since enumeration

NPPES CertifiedOctober 26, 2020

✔ NPI 1013401561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiology · Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207LP2900X

Definition

An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

57 OFFICE PARK DR, Jacksonville, NC 28546

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2084239

Crystal Coast Pain Management · Jacksonville, NC

Active · expires Sep 21, 2026

CLIA Number34D2084239

Laboratory TypePhysician Office

Certificate Effective DateSeptember 22, 2024

Certificate Expiration DateSeptember 21, 2026

Laboratory DirectorKirk Harum

Laboratory Phone(910) 353-6008

Laboratory LocationCrystal Coast Pain Management57 Office Park Drive, Jacksonville, NC 28546

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. RACHEL MEADOR BENNETT PA-C

Physician Assistant