Individual provider Active NPI

Michelle Marie Crook, RESPIRATORY CARE PRA

  • Pulmonary Diagnostics Certified Respiratory Therapist
  • San Rafael, CA
National Provider Identifier
1750815908
Registry record updated Apr 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Diagnostics Certified Respiratory TherapistTaxonomy code 2278P1004X
License
0021376 Issued in CA
Practice address
1012 Los Gamos Rd Apt D
San Rafael, CA 94903-2532
Phone
(415) 419-4325
NPI assigned
Apr 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Diagnostics Certified Respiratory Therapist 2278P1004X 0021376 CA Primary

Addresses

Primary practice location

1012 Los Gamos Rd Apt D
San Rafael, CA 94903-2532

Mailing address

1012 Los Gamos Rd Apt D
San Rafael, CA 94903-2532
Phone (415) 419-4325

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
0021376CAMDPulmonary Diagnostics Certified Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1750815908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 LOS GAMOS RD APT D",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032532",
            "telephone_number": "415-419-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 LOS GAMOS RD APT D",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032532",
            "telephone_number": "415-419-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOK",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "RESPIRATORY CARE PRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-14",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2278P1004X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified, Pulmonary Diagnostics",
            "state": "CA",
            "license": "0021376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; 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.