Individual provider Active NPI

Amanda Brooke Crumbey, RN

  • Registered Nurse
  • Oxford, MS
National Provider Identifier
1376022616
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
900593 Issued in MS
Practice address
152 Highway 7 S
Oxford, MS 38655-5392
Phone
(662) 234-7521
Fax
(662) 236-3071
NPI assigned
Aug 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X R900593 MS
Registered Nurse 163W00000X 900593 MS Primary

Addresses

Primary practice location

152 Highway 7 S
Oxford, MS 38655-5392

Mailing address

152 Highway 7 S
Oxford, MS 38655-5392
Phone (662) 234-7521

Other practice location 1

394.3 Highway 160
Kayenta, AZ 86033
Phone (928) 697-4100

Other identifiers 1

IdentifierTypeStateIssuer
R900593OtherMSREGISTERED NURSE

Other names 1

  • Amanda Brooke Moore Former name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
900593MSMDRegistered Nurse
R900593MSMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1376022616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 HIGHWAY 7 S",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555392",
            "telephone_number": "662-234-7521",
            "fax_number": "662-236-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 HIGHWAY 7 S",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555392",
            "telephone_number": "662-234-7521",
            "fax_number": "662-236-3071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "394.3 Highway 160",
            "address_purpose": "LOCATION",
            "city": "Kayenta",
            "state": "AZ",
            "postal_code": "86033",
            "country_code": "US",
            "telephone_number": "928-697-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUMBEY",
        "first_name": "AMANDA",
        "middle_name": "BROOKE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "MS",
            "license": "R900593",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "900593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "R900593",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "MOORE",
            "middle_name": "BROOKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.