Individual provider Active NPI

Jessica Crawford-Rosado

  • Licensed Practical Nurse
  • Coram, NY
National Provider Identifier
1306635834
Registry record updated Nov 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
350578 Issued in NY
Practice address
2106 Townehouse Dr
Coram, NY 11727-2879
Phone
(631) 559-5838
NPI assigned
May 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 350578 NY Primary

Addresses

Primary practice location

2106 Townehouse Dr
Coram, NY 11727-2879

Mailing address

2106 Townehouse Dr
Coram, NY 11727-2879
Phone (631) 566-0101

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

State licenses

LicenseStateTypeSpecialty
350578NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764288000000",
    "number": "1306635834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 TOWNEHOUSE DR",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117272879",
            "telephone_number": "631-566-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 TOWNEHOUSE DR",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117272879",
            "telephone_number": "631-559-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD-ROSADO",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "350578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coram, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2025; 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.