Individual provider Active NPI

Calie Nicole Crosgrove, LPN

  • Licensed Practical Nurse
  • Bismarck, ND
National Provider Identifier
1366267692
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
L16020 Issued in ND
Practice address
2700 State St
Bismarck, ND 58503-0669
Phone
(701) 221-9152
Fax
(701) 221-0918
NPI assigned
Nov 21, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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 L16020 ND Primary

Addresses

Primary practice location

2700 State St
Bismarck, ND 58503-0669

Mailing address

2700 State St
Bismarck, ND 58503-0669
Phone (701) 221-9152

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
L16020NDMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1366267692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STATE ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030669",
            "telephone_number": "701-221-9152",
            "fax_number": "701-221-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 STATE ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030669",
            "telephone_number": "701-221-9152",
            "fax_number": "701-221-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSGROVE",
        "first_name": "CALIE",
        "middle_name": "NICOLE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "ND",
            "license": "L16020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.