Individual provider Active NPI

Veronica Jetzabe Crump

  • Medical Physician Assistant
  • Cary, NC
National Provider Identifier
1740738061
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-06739 Issued in NC
Practice address
3700 NW Cary Pkwy Ste 110
Cary, NC 27513-8446
Phone
(919) 238-2000
Fax
(919) 238-5010
NPI assigned
Sep 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-06739 NC
Medical Physician Assistant 363AM0700X 0010-06739 NC Primary

Addresses

Primary practice location

3700 NW Cary Pkwy Ste 110
Cary, NC 27513-8446

Mailing address

PO Box 604337
Charlotte, NC 28260-4337
Phone (919) 238-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170303000637 NC Practitioner - Physician Assistant 3476837899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3700 NW Cary Pkwy
Suite 110
Cary, NC 27513-8446
Phone (919) 238-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-06739NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Triangle Medical Group, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

3700 NW Cary Pkwy
Ste 110
Cary, NC 27513
Phone (919) 319-3649

1070 S Main St
Ste 130
Holly Springs, NC 27540

8300 Health Park
Ste 107
Raleigh, NC 27615
Phone (919) 846-7312

Interoperability endpoints

  • Direct secure messaging: vcrump1623321@direct.novanthealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1740738061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604337",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604337",
            "telephone_number": "919-238-2000",
            "fax_number": "919-238-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 NW CARY PKWY STE 110",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138446",
            "telephone_number": "919-238-2000",
            "fax_number": "919-238-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMP",
        "first_name": "VERONICA",
        "middle_name": "JETZABE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2025-01-02",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06739",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-06739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.