MISS CRYSTAL B CLARK FNP-C
NPI 1154898179
Family Medicine in Pageland, SC

Q: What is Crystal Clark's NPI number?

The NPI number for Crystal Clark is 1154898179. It was assigned to this individual provider in the NPPES registry on October 29, 2018.

Q: What is Crystal Clark's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Crystal Clark was last updated on July 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 29, 2018PECOS Enrolled

211 S PEARL ST STE B, PAGELAND, SC 29728(803) 288-9495(989) 214-7326 Get Directions Write a Review

NPPES record last updated: July 23, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 23, 2026, Mar 8, 2026, Jan 29, 2026 and 10 more (13 updates tracked since 2018).

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About Miss Crystal B Clark Fnp-c NPPES

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

MISS CRYSTAL B CLARK FNP-C (NPI 1154898179) is an individual family medicine provider in Pageland, South Carolina, licensed in South Carolina (22378) and active in the NPI registry since October 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154898179

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameMISS CRYSTAL B CLARKCredential: FNP-C

Location Address211 S PEARL ST STE BPageland, SC 29728-2261

Mailing Address211 S Pearl St Ste BPageland, SC 29728-2261 · (843) 675-5070 · Fax (989) 214-7326

Phone(803) 288-9495

Fax(989) 214-7326

Sole ProprietorNo

Enumeration DateOctober 29, 2018

Last NPPES UpdateJuly 23, 202613 updates tracked since enumeration

NPPES CertifiedJuly 23, 2026

✔ NPI 1154898179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in SC · 22378

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 22378 (SC)

211 S PEARL ST STE B, Pageland, SC 29728

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Other Identifiers 2

Other22378SC · Aprn Licensure

MedicaidNP5853SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Crystal B Clark Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Crystal Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern Charm Medical And Wellness, LLC

Same address

Family Medicine

211 S PEARL ST STE B
Pageland, SC 29728

Reassigned Medicare billing, South Carolina enrollment

NPI 1659121614 (843) 675-5070

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29728 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

SOUTHERN CHARM MEDICAL AND WELLNESS, LLC

Family Medicine

211 S PEARL ST STE B
PAGELAND, SC 29728

Chesterfield County (843) 675-5070

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal Clark's NPI number?

The NPI number for Crystal Clark is 1154898179. It was assigned to this individual provider in the NPPES registry on October 29, 2018.

Where is Crystal Clark located?

Crystal Clark practices at 211 S Pearl St Ste B, Pageland, SC 29728. The listed phone number is (803) 288-9495.

What is Crystal Clark's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Crystal Clark enrolled in Medicare?

Yes. Crystal Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Crystal Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Crystal Clark reassigns Medicare benefits to Southern Charm Medical And Wellness, LLC (Pageland, SC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Crystal Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Crystal Clark accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina and UnitedHealthcare list Crystal Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Crystal Clark was last updated on July 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.