Individual provider Active NPI

Naomi J Crouse

  • Physical Therapy Assistant
  • Port St Lucie, FL
National Provider Identifier
1669782199
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
22346 Issued in FL
Practice address
7300 Oleander Ave
Port St. Lucie, FL 34592
Phone
(772) 595-0410
NPI assigned
Oct 18, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 22346 FL Primary

Addresses

Primary practice location

7300 Oleander Ave
Port St. Lucie, FL 34592

Mailing address

5896 NW Leah Dr
Port St. Lucie, FL 34986
Phone (239) 822-8977

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

State licenses

LicenseStateTypeSpecialty
22346FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1669782199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5896 NW LEAH DR",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34986",
            "telephone_number": "239-822-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 OLEANDER AVE",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34592",
            "telephone_number": "772-595-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUSE",
        "first_name": "NAOMI",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "22346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.