Active NPI
Samantha Crum
- Occupational Therapist
- Wake Forest, NC
National Provider Identifier
1760286488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 17491
- Practice address
- 1521 Old Weaver TRL
Wake Forest, NC 27587-8660 - Phone
- (919) 719-6341
- NPI assigned
- Apr 2, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 17491 | NC | Primary |
Addresses
Primary practice location
1521 Old Weaver TRL
Wake Forest, NC 27587-8660
Mailing address
1521 Old Weaver TRL
Wake Forest, NC 27587-8660
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17491 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743552000000",
"number": "1760286488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1521 OLD WEAVER TRL",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275878660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1521 OLD WEAVER TRL",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275878660",
"telephone_number": "919-719-6341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUM",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-02",
"last_updated": "2025-04-02",
"certification_date": "2025-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "17491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.