Michael Crooks

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11020834 Issued in FL

Practice address

860 Camp Rd
Cocoa, FL 32927-3708

Phone

(321) 690-1500

NPI assigned

Sep 2, 2022

Last updated

Mar 8, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1649990151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 COSTA MESA LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347447235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 CAMP RD",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329273708",
            "telephone_number": "321-690-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOKS",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-02",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11020834",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "APRN11020834",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Cocoa, FL
• Providers in Cocoa, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.