Active NPI
Chuckeia V Crumbley, CNA, HHA
- Nurse's Aide
- Saint Petersburg, FL
National Provider Identifier
1871164590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 329492
- Practice address
- 1400 13TH St S
Saint Petersburg, FL 33705-2410 - Phone
- (727) 509-5523
- NPI assigned
- Jul 3, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | |||
| Home Health Aide | 374U00000X | |||
| Homemaker | 376J00000X | |||
| Nurse's Aide | 376K00000X | 329492 | FL | Primary |
Addresses
Primary practice location
1400 13TH St S
Saint Petersburg, FL 33705-2410
Mailing address
PO Box 35348
Saint Petersburg, FL 33705-0506
Phone (727) 509-5523
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C651118859280 | Other | FL | DRIVER LIC |
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 |
|---|---|---|---|
| 329492 | FL | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625270400000",
"number": "1871164590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 35348",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337050506",
"telephone_number": "727-509-5523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 13TH ST S",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337052410",
"telephone_number": "727-509-5523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUMBLEY",
"first_name": "CHUCKEIA",
"middle_name": "V",
"credential": "CNA, HHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-03",
"last_updated": "2021-07-03",
"certification_date": "2021-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": false
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "FL",
"license": "329492",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER LIC",
"identifier": "C651118859280",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.