Omodelle Fitzherbert Crum-Ewing, RN (BSN)

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

535857 Issued in NY

Practice address

4165 Hill Ave
Bronx, NY 10466-2105

Phone

(646) 938-8603

Fax

(718) 547-4147

NPI assigned

Dec 19, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1063696532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4165 HILL AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662105",
            "telephone_number": "646-938-8603",
            "fax_number": "718-547-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 HILL AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662105",
            "telephone_number": "646-938-8603",
            "fax_number": "718-547-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUM-EWING",
        "first_name": "OMODELLE",
        "middle_name": "FITZHERBERT",
        "name_prefix": "Mr.",
        "credential": "RN  (BSN)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "535857",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "535857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• School Registered Nurse in Bronx, NY
• Providers in Bronx, NY by specialty
• School Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.