Mary Crumbliss, MSN, CPNP-PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN298923 Issued in GA

Practice address

10710 Medlock Bridge Rd Ste 250
Johns Creek, GA 30097-1999

Phone

(770) 870-1085

Fax

(770) 870-1086

NPI assigned

Dec 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcrumbliss625478@directwellstar.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Urgent Care for Children, PLLC

  • Pediatrics Physician
  • Hixson, TN
  • NPI 1205434420

  Nurse Practitioner

  Medicare reassignment NPD
• Baybol Pediatrics LLC

  • Pediatrics Physician
  • Atlanta, GA
  • NPI 1760858252
  NPD (past)

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1144825415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 MEDLOCK BRIDGE RD STE 250",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971999",
            "telephone_number": "770-870-1085",
            "fax_number": "770-870-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 MEDLOCK BRIDGE RD STE 250",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971999",
            "telephone_number": "770-870-1085",
            "fax_number": "770-870-1086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "388 Fox Trot Trl",
            "address_purpose": "LOCATION",
            "city": "Ringgold",
            "state": "GA",
            "postal_code": "307367367",
            "country_code": "US",
            "telephone_number": "423-838-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUMBLISS",
        "first_name": "MARY",
        "credential": "MSN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN298923",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "APN0000028490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcrumbliss625478@directwellstar.org",
            "affiliation": "N",
            "address_1": "10710 Medlock Bridge Rd Ste 250",
            "city": "Johns Creek",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300971999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Creekview Pediatrics LLC
• Joshua Crockett, LCSW
• Constance Cromartie, LPC
• Megan Elizabeth Cronic, SLP
• Katelyn Nicole Crook
• Lisa Lillich Culpepper, MD
• Timothy Alan Cummins, PTA
• Mesa Montia Curney, RN
• Frank David Curvin, M.D.
• Brittany Lauren Cutler, LMSW

• Nurse Practitioner in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.