Amy Rose Crum, APNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

15474-33 Issued in WI

Practice address

4536 22ND Ave
Kenosha, WI 53140-5917

Phone

(262) 771-0070

Fax

(262) 885-6340

NPI assigned

Jun 19, 2024

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Kenosha Community Health Center, Inc.Group PAC ID 0941195168, 19 clinicians

Yusuf Salah LLCGroup PAC ID 3577895176, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: acrum657863@direct.ochin.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.

• Kenosha Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kenosha, WI
  • NPI 1265435960

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Yusuf Salah LLC

  • Family Nurse Practitioner
  • Palos Heights, IL
  • NPI 1982254850

  WI

  Medicare reassignment Care Compare group NPD
• Kenosha Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Silver Lake, WI
  • NPI 1568931541
  NPD
• Kenosha Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Racine, WI
  • NPI 1215823406
  NPD
• Kenosha Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Kenosha, WI
  • NPI 1710635677
  NPD (past)
• Liz Hanson Will, LLC

  • Clinical Social Worker
  • Mount Pleasant, WI
  • NPI 1043888902
  NPD (past)

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1295579951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4006 WASHINGTON RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531444819",
            "telephone_number": "262-656-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4536 22ND AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531405917",
            "telephone_number": "262-771-0070",
            "fax_number": "262-885-6340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "903 S 2nd St",
            "address_purpose": "LOCATION",
            "city": "Silver Lake",
            "state": "WI",
            "postal_code": "531701747",
            "country_code": "US",
            "telephone_number": "262-656-0044",
            "fax_number": "262-885-6340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4006 Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531444819",
            "country_code": "US",
            "telephone_number": "262-656-0044",
            "fax_number": "262-885-6340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6226 14th Ave",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531434413",
            "country_code": "US",
            "telephone_number": "262-656-0044",
            "fax_number": "262-885-6340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUM",
        "first_name": "AMY",
        "middle_name": "ROSE",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "15474-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "15474-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100285100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David J. Crewe, D.D.S.
• Nathan James Croatt, OTR/L
• Crossroads Care Center of Kenosha
• Crowe Group LTD.
• Wendy Susan Crowe-Haugstad, DDS
• Ctvsa Wisconsin S.C.
• Robin Cullen
• Monica Lillian Cummings
• Sara Cummings
• Katherine Mary Czajka, P.T.

• Family Nurse Practitioner in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.