Stephanie Crum, PA

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

9117891 Issued in FL

Practice address

19621 Cochran Blvd
Port Charlotte, FL 33948-2070

Phone

(954) 262-1250

NPI assigned

Jan 4, 2022

Last updated

Oct 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1396406120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 LOMOND DR",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339531526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19621 COCHRAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339482070",
            "telephone_number": "954-262-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUM",
        "first_name": "STEPHANIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2023-10-03",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "9117891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Crist, OTR/L
• Carissa Crites
• Erica Cromwell
• Kristina Crook
• Randall Crouch, LMHC
• Edgar Joel Cruz Crispin, DNP, APRN
• Karina Cruz, ARNP
• Daniel Cueto, M.D.
• Kathleen Cullen, PA
• Mabel Sunio Cunanan, PT

• Interventional Pain Medicine Physician in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Interventional Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.