Samantha Jo Crusenberry, WHNP

Primary specialty

Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X

License

28222223A Issued in IN

Practice address

650 S Walker St
Bloomington, IN 47403-2158

Phone

(812) 334-0698

NPI assigned

Oct 16, 2020

Last updated

Oct 16, 2020By 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

Other names 1

• Samantha Jo Boligner Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• John Labban MD PC

  dba Women's Health

  • Specialist
  • Bloomington, IN
  • NPI 1508040593
  Medicare reassignment NPD

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1538767041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 S WALKER ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032158",
            "telephone_number": "812-334-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 S WALKER ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032158",
            "telephone_number": "812-334-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUSENBERRY",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-16",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "IN",
            "license": "28222223A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scrusenberry@iuhealth.org",
            "affiliation": "N",
            "endpointDescription": "IU Health Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "650 S Walker St",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474032158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "BOLIGNER",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Emily Nicole Crum, M.A., CCC-SLP
• CS Dental LLC
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• Kate Bodack Cullison, PHD
• Ashleigh Hope Cummings, OTR
• Bonnie Rae Cummings, PTA

• Ambulatory Women's Health Care Registered Nurse in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Ambulatory Women's Health Care Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.