Individual provider Active NPI

Edward Jason Crum, HEALTH SERVICE TECH.

  • Other Technician
  • Jacksonville, FL
National Provider Identifier
1376683243
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
4200 Ocean St
Jacksonville, FL 32233-2416
Phone
(904) 564-7581
Fax
(904) 564-7583
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X B1757148 CA
Other Technician 247200000X CA Primary

Addresses

Primary practice location

4200 Ocean St
Jacksonville, FL 32233-2416

Mailing address

4200 Ocean St
Jacksonville, FL 32233-2416
Phone (904) 564-7581

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
B1757148CAMDBasic Emergency Medical Technician

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1376683243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 OCEAN ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322332416",
            "telephone_number": "904-564-7581",
            "fax_number": "904-564-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 OCEAN ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322332416",
            "telephone_number": "904-564-7581",
            "fax_number": "904-564-7583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUM",
        "first_name": "EDWARD",
        "middle_name": "JASON",
        "name_prefix": "Mr.",
        "credential": "HEALTH SERVICE TECH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "B1757148",
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.