Kelly Crawford

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

740812 Issued in NY

Practice address

11 Baker St
Patchogue, NY 11772-3846

Phone

(631) 480-7551

NPI assigned

Jun 19, 2022

Last updated

Jun 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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

{
    "created_epoch": "1655596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655596800000",
    "number": "1164153474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BAKER ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BAKER ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723846",
            "telephone_number": "631-480-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-19",
        "last_updated": "2022-06-19",
        "certification_date": "2022-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "740812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura N Costello, LPN
• Country Foot Care Podiatry PLLC
• County of Suffolk (South Brookhaven Health Center West)
• Novelle A. Court
• Antoine Craig
• Corie Leon Crews Sr., LCSW
• Annette Mahoney Cross, LMSW
• Natasha Cruz, LMSW
• Courtney Culkin, LMHC
• Charlene Cunningham, B.S. SPECIAL EDUCATI

• Registered Nurse in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2022; 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.