Active NPI
Mary Crouch III
- Registered Nurse
- Las Cruces, NM
National Provider Identifier
1417106402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R23247
- Practice address
- 118 S. Main
Las Cruces, NM 88001 - Phone
- (575) 527-7984
- NPI assigned
- Sep 15, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R23247 | NM | Primary |
Addresses
Primary practice location
118 S. Main
Las Cruces, NM 88001
Mailing address
100 W Griggs Ave
Las Cruces, NM 88001-1234
Phone (575) 647-2800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 850204142 | Other | NM | MEDICARE |
| 47043 | Medicaid | NM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R23247 | NM | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221436800000",
"number": "1417106402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 W GRIGGS AVE",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880011234",
"telephone_number": "575-647-2800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 S. MAIN",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "88001",
"telephone_number": "575-527-7984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROUCH",
"first_name": "MARY",
"name_suffix": "III",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-15",
"last_updated": "2008-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NM",
"license": "R23247",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "850204142",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47043",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.