Individual provider Active NPI

Jamie Lynn Crumley, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1629532387
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP221347 Issued in AZ
Practice address
610 E Baseline Rd Ste 5
Phoenix, AZ 85042-6536
Phone
(602) 230-7373
Fax
(602) 441-5836
NPI assigned
Jan 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 221347 AZ
Psychiatric/Mental Health Registered Nurse 163WP0808X RN169018 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP221347 AZ Primary

Addresses

Primary practice location

610 E Baseline Rd Ste 5
Phoenix, AZ 85042-6536

Mailing address

3101 N Central Ave Ste 550
Phoenix, AZ 85012-2635
Phone (602) 230-7373

Other identifiers 1

IdentifierTypeStateIssuer
495818MedicaidAZ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcrumley@denova.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20190611001375 AZ Practitioner - Nurse Practitioner 3173856986 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Quack Health PLLCGroup PAC ID 5193184505, 7 clinicians

Practice addresses (Care Compare)

3404 W Cheryl Dr
Suite A150
Phoenix, AZ 85051-9615
Phone (602) 503-2832

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN169018AZMDPsychiatric/Mental Health Registered Nurse
AP221347AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quack Health PLLC Psychiatric/Mental Health CurrentSince Dec 1, 2024 Accepting new patients
Denova Collaborative Health, LLC CurrentSince Feb 1, 2019 Accepting new patients
Denova Collaborative Health, LLC Current Accepting new patients
Denova Collaborative Health, LLC CurrentSince Feb 1, 2019 Accepting new patients

Locations

235 W Western Ave
Avondale, AZ 85323
Phone (623) 772-5091

2204 S Dobson Rd
Ste 201
Mesa, AZ 85202
Phone (602) 374-4410

2204 S Dobson Rd
Ste 102
Mesa, AZ 85202

610 E Baseline Rd
Ste 5
Phoenix, AZ 85042

3101 N Central Ave
Ste 550
Phoenix, AZ 85012

3404 W Cheryl Dr
Ste A150
Phoenix, AZ 85051
Phone (480) 863-5250

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

77 E Columbus Ave
Ste 210
Phoenix, AZ 85012

3620 N 3rd St
Phoenix, AZ 85012
Phone (602) 329-8250

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

9014 S Central Ave
Ste 210
Phoenix, AZ 85042

Organizations & group practices 4

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": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1629532387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 550",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122635",
            "telephone_number": "602-230-7373",
            "fax_number": "602-682-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E BASELINE RD STE 5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426536",
            "telephone_number": "602-230-7373",
            "fax_number": "602-441-5836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMLEY",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-28",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "221347",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "RN169018",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP221347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495818",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcrumley@denova.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "610 E Baseline Rd Ste 5",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850426536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.