Individual provider Active NPI

Brianna Jessup Crummey, NP

  • Family Nurse Practitioner
  • Eastman, GA
National Provider Identifier
1316509771
Registry record updated Jul 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN258688 Issued in GA
Practice address
911 Plaza Ave Ste C
Eastman, GA 31023-6786
Phone
(478) 374-5774
NPI assigned
Jul 5, 2019
Last updated
Jul 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN258688 GA Primary

Addresses

Primary practice location

911 Plaza Ave Ste C
Eastman, GA 31023-6786

Mailing address

309 Bell Line Rd
Eastman, GA 31023-2637
Phone (478) 231-9729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20191216000386 GA Practitioner - Nurse Practitioner 7618300195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Heart of Georgia Primary Care, LLCGroup PAC ID 3678809167, 4 clinicians

Practice addresses (Care Compare)

911 Plaza Ave
Suite C
Eastman, GA 31023-6786
Phone (478) 374-5774

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN258688GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heart of Georgia Primary Care, LLC Family CurrentSince Sep 22, 2019 Accepting new patients

Locations

150 E Peacock St
#A
Cochran, GA 31014
Phone (478) 271-3200

911 Plaza Ave
Ste C
Eastman, GA 31023
Phone (478) 231-5948

Interoperability endpoints

  • Direct secure messaging: brianna.crummey@mtpm.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/AEADBA

Organizations & group practices 1

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1316509771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 BELL LINE RD",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310232637",
            "telephone_number": "478-231-9729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 PLAZA AVE STE C",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236786",
            "telephone_number": "478-374-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMMEY",
        "first_name": "BRIANNA",
        "middle_name": "JESSUP",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-05",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN258688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastman, GA

Sources for this page

Verify at the official NPI Registry.