Active NPI
Lynn Mary Crymes, PNP
- Pediatric Nurse Practitioner
- Portland, OR
National Provider Identifier
1669667697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 000027327N2
- Practice address
- 426 SW Stark St
8TH Floor
Portland, OR 97204-2347 - Phone
- (503) 988-3674
- Fax
- (503) 988-3676
- NPI assigned
- Sep 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 000027327N2 | OR | Primary |
Addresses
Primary practice location
426 SW Stark St
8TH Floor
Portland, OR 97204-2347
Mailing address
426 SW Stark St
8TH Floor
Portland, OR 97204-2347
Phone (503) 988-3674
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022959 | Medicaid | OR |
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)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000027327N2 | OR | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189555200000",
"number": "1669667697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "426 SW STARK ST",
"address_2": "8TH FLOOR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972042347",
"telephone_number": "503-988-3674",
"fax_number": "503-988-3676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "426 SW STARK ST",
"address_2": "8TH FLOOR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972042347",
"telephone_number": "503-988-3674",
"fax_number": "503-988-3676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRYMES",
"first_name": "LYNN",
"middle_name": "MARY",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-12",
"last_updated": "2007-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "OR",
"license": "000027327N2",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "022959",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.