Individual provider Active NPI

Amy W. Crisp, CRNA

  • Certified Registered Nurse Anesthetist
  • New Brunswick, NJ
National Provider Identifier
1447392873
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ00214100 Issued in NJ
Practice address
1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone
(732) 937-8841
Fax
(732) 418-8492
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 26NJ00214100 NJ Primary

Addresses

Primary practice location

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928

Mailing address

66 W Gilbert St
2ND Floor
Tinton Falls, NJ 07701-4947
Phone (732) 212-0051

Other identifiers 1

IdentifierTypeStateIssuer
0224073MedicaidNJ

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ00214100NJMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1447392873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W GILBERT ST",
            "address_2": "2ND FLOOR",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014947",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-937-8841",
            "fax_number": "732-418-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISP",
        "first_name": "AMY",
        "middle_name": "W.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ00214100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0224073",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; 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.