Individual provider Active NPI

Cornelia Mathilde Crites, RN,.RND.

  • Registered Nurse
  • Vancouver, WA
National Provider Identifier
1083030001
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN00122960 Issued in WA
Practice address
320 W 28TH St
Vancouver, WA 98660-2110
Phone
(360) 258-3153
Fax
(360) 695-7794
NPI assigned
Mar 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00122960 WA Primary

Addresses

Primary practice location

320 W 28TH St
Vancouver, WA 98660-2110

Mailing address

320 W 28TH St
Vancouver, WA 98660-2110
Phone (360) 258-3153

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN00122960WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1083030001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W 28TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602110",
            "telephone_number": "360-258-3153",
            "fax_number": "360-695-7794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W 28TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602110",
            "telephone_number": "360-258-3153",
            "fax_number": "360-695-7794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRITES",
        "first_name": "CORNELIA",
        "middle_name": "MATHILDE",
        "name_prefix": "Mrs.",
        "credential": "RN,.RND.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-14",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00122960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; 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.