Individual provider Active NPI

Thomas Alan Crum, PH.D.

  • Clinical Neuropsychologist
  • Hampton, VA
National Provider Identifier
1811053739
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
0810007760 Issued in VA
Practice address
4000 Coliseum Dr Ste 200
Hampton, VA 23666-5975
Phone
(757) 736-8050
NPI assigned
Dec 28, 2006
Last updated
Nov 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 0810007760 VA Primary
Psychologist 103T00000X PY6720 FL

Addresses

Primary practice location

4000 Coliseum Dr Ste 200
Hampton, VA 23666-5975

Mailing address

4000 Coliseum Dr Ste 200
Hampton, VA 23666-5975
Phone (757) 736-8050

Other practice location 1

201 E Sample Rd Fl 1
Deerfield Beach, FL 33064-3502
Phone (954) 786-7392

Other identifiers 1

IdentifierTypeStateIssuer
107559100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110628000863 FL Practitioner - Clinical Psychologist 6901709401 Reassigns benefits to 1 organization
I20231204002678 VA Practitioner - Clinical Psychologist 6901709401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

4000 Coliseum Dr
Suite 200
Hampton, VA 23666-5975
Phone (757) 736-8050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810007760VAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Aug 1, 2014 Accepting new patients
South Broward Hospital District Clinical Neuropsychologist CurrentSince Aug 1, 2014 Accepting new patients
Sentara Medical Group CurrentSince Sep 23, 2023 Accepting new patients
Cme Psychology Consultants PA PastSince Jan 2, 2012 Accepting new patients
Mauro Reynolds & Associates in Counseling Inc Past Accepting new patients

Locations

3600 Washington St
Ste 2005
Hollywood, FL 33021
Phone (954) 518-2424

3600 Washington St
Ste 311
Hollywood, FL 33021
Phone (954) 518-5507

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

4000 Coliseum Dr
Ste 200
Hampton, VA 23666
Phone (757) 736-8050

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

Organizations & group practices 5

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1811053739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 COLISEUM DR STE 200",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665975",
            "telephone_number": "757-736-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 COLISEUM DR STE 200",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665975",
            "telephone_number": "757-736-8050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E Sample Rd Fl 1",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "330643502",
            "country_code": "US",
            "telephone_number": "954-786-7392",
            "fax_number": "954-786-7339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUM",
        "first_name": "THOMAS",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810007760",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6720",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107559100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.