Individual provider Active NPI

Chuckeia V Crumbley, CNA, HHA

  • Nurse's Aide
  • Saint Petersburg, FL
National Provider Identifier
1871164590
Registry record updated Jul 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
329492 Issued in FL
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

Updated by the provider on Jul 3, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X
Home Health Aide 374U00000X
HomemakerGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
C651118859280OtherFLDRIVER 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

LicenseStateTypeSpecialty
329492FLMDNurse'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.

Verify at the official NPI Registry.