Ethel L Crosby, EARLY INTERVENTION

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

5541 1St Ave N
Saint Petersburg, FL 33710-8005

Phone

(727) 767-4403

Fax

(727) 767-4715

NPI assigned

Sep 4, 2007

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 identifiers 1

Other names 1

• Mrs. Ethel L Bismarck Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1679767545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5541 1ST AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337108005",
            "telephone_number": "727-767-4403",
            "fax_number": "727-767-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5541 1ST AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337108005",
            "telephone_number": "727-767-4403",
            "fax_number": "727-767-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSBY",
        "first_name": "ETHEL",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "EARLY INTERVENTION",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "812163000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ETHEL",
            "last_name": "BISMARCK",
            "middle_name": "L",
            "prefix": "MRS.",
            "credential": "EARLY INTERVENTION",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Crna Services of Punta Gorda PA
• Melissa Croce
• Charamine E Crockett
• Heidi Crockett, LCSW, LMT
• Octavia G. Crooks, LPN
• Marie Crosby
• Nia Crosby
• Caitlin J Crosier, MD
• Kelli A Cross, MD
• Vicki Cross, APRN

• Developmental Therapist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.