Individual provider Active NPI

Sheri L Crummey, FNP-C

  • Family Nurse Practitioner
  • Hurst, TX
National Provider Identifier
1417097643
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP115565 Issued in TX
Practice address
1717 Precinct Line Rd Ste 200
Hurst, TX 76054-3197
Phone
(817) 369-3990
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 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 AP115565 TX Primary

Addresses

Primary practice location

1717 Precinct Line Rd Ste 200
Hurst, TX 76054-3197

Mailing address

504 N Reo St
Tampa, FL 33609-1013
Phone (813) 549-2134

Other identifiers 1

IdentifierTypeStateIssuer
201127050AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070920000327 TX Practitioner - Nurse Practitioner 5294829305 Reassigns benefits to 1 organization
I20160129001768 KS Practitioner - Nurse Practitioner 5294829305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Pain Relief Group PLLCGroup PAC ID 2668603952, 14 clinicians

Practice addresses (Care Compare)

1717 Precinct Line Rd
Suite 200
Hurst, TX 76054-3197
Phone (817) 369-3990

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Pain Relief Group PLLC CurrentSince Jan 8, 2020 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Feb 15, 2016 Accepting new patients
Texas Pain Relief Group, PLLC CurrentSince Jan 8, 2020 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Feb 15, 2016 Accepting new patients
Texas Pain Relief Group PLLC Family Past Accepting new patients

Locations

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

14700 W Saint Teresa St
Ste 300
Wichita, KS 67235
Phone (316) 274-0142

1717 Precinct Line Rd
Ste 200
Hurst, TX 76054
Phone (817) 369-3990

Interoperability endpoints

  • Direct secure messaging: sheri.crummey@ppoa.directbygreenway.com

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1417097643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 N REO ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091013",
            "telephone_number": "813-549-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 PRECINCT LINE RD STE 200",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543197",
            "telephone_number": "817-369-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMMEY",
        "first_name": "SHERI",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP115565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201127050A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurst, TX

Sources for this page

Verify at the official NPI Registry.