Individual provider Active NPI

Gloria M. Crespo, LPN

  • Licensed Practical Nurse
  • New City, NY
National Provider Identifier
1881979771
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
168646 Issued in NY
Practice address
169 S Main St # 344
New City, NY 10956-3353
Phone
(646) 450-8455
Fax
(646) 570-1986
NPI assigned
Oct 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 168646 NY Primary

Addresses

Primary practice location

169 S Main St # 344
New City, NY 10956-3353

Mailing address

169 S Main St # 344
New City, NY 10956-3353
Phone (646) 450-8455

Other identifiers 1

IdentifierTypeStateIssuer
03382414MedicaidNY

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
168646NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Care Core Solutions, LLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1881979771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 S MAIN ST # 344",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109563353",
            "telephone_number": "646-450-8455",
            "fax_number": "646-570-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 S MAIN ST # 344",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109563353",
            "telephone_number": "646-450-8455",
            "fax_number": "646-570-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESPO",
        "first_name": "GLORIA",
        "middle_name": "M.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "168646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03382414",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.