Active NPI
Marlon D Crum
- Private Vehicle
- Youngstown, OH
National Provider Identifier
1063088698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- RZ574107
- Practice address
- 120 Illinois Ave
Youngstown, OH 44505-2874 - Phone
- (440) 444-4226
- NPI assigned
- Jun 3, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | RZ574107 | OH | |
| Private Vehicle | 347C00000X | RZ574107 | OH | Primary |
Addresses
Primary practice location
120 Illinois Ave
Youngstown, OH 44505-2874
Mailing address
120 Illinois Ave
Youngstown, OH 44505-2874
Phone (440) 444-4226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RZ574107 | OH | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622678400000",
"number": "1063088698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 ILLINOIS AVE",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445052874",
"telephone_number": "440-444-4226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 ILLINOIS AVE",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445052874",
"telephone_number": "440-444-4226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUM",
"first_name": "MARLON",
"middle_name": "D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-03",
"last_updated": "2021-06-03",
"certification_date": "2021-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "OH",
"license": "RZ574107",
"primary": false
},
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "OH",
"license": "RZ574107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.