Opal Wendy Croom, REGISTERED NURSE

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

690310 Issued in TX

Practice address

21227 Torch Road
Fort Bliss, TX 79901

Phone

(915) 742-7263

Fax

(915) 742-3098

NPI assigned

Dec 9, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1710793278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3656 TIERRA LISBOA LN",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799384317",
            "telephone_number": "206-718-5047",
            "fax_number": "915-742-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21227 TORCH ROAD",
            "city": "FORT BLISS",
            "state": "TX",
            "postal_code": "79901",
            "telephone_number": "915-742-7263",
            "fax_number": "915-742-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOM",
        "first_name": "OPAL",
        "middle_name": "WENDY",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "TX",
            "license": "690310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly R Cooper, OTR/L
• Sylvia Patricia Corchado
• Luis Cortez II, P.T.
• George Cortinas, PHARMD
• Jordan Council, DO
• Maria Virginia Cinco Cuayzon, PA-C
• Min Cui, MD
• Carey Marie Curran, LMSW-CLINICAL
• Rachel Curtis
• Jason Daniels, PA-C

• Case Management Registered Nurse in Fort Bliss, TX
• Providers in Fort Bliss, TX by specialty
• Case Management Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.