Amanda Renee Crouch, NPI

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

68222 Issued in NM

Practice address

1400 Barbara Loop SE
Rio Rancho, NM 87124-1088

Phone

(505) 414-6449

NPI assigned

Jun 27, 2022

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

Enrolled in NM

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 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Omni Medical Group LLCGroup PAC ID 6709049745, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Omni Medical Group LLC

  dba Clinica La Esperanza

  • Clinic/Center
  • Albuquerque, NM
  • NPI 1568768042
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1477285567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8416 HILTON AVE NE APT 9B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113134",
            "telephone_number": "505-280-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BARBARA LOOP SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241088",
            "telephone_number": "505-414-6449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "AMANDA",
        "middle_name": "RENEE",
        "credential": "NPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NM",
            "license": "68222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Creelman, LMSW
• Ashley Crespin
• John Francis Crisler, D.D.S.
• Jennifer Crispo, LMFT
• Shirley Mae Crotwell, PHD
• Jenee Crow, CNP
• Faith Crowe
• Dianne M Crowley, RD
• Crucible Counseling LLC
• Sandra M Crum, LD

• Primary Care Nurse Practitioner in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• Primary Care Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.