Roy Edward Crumley-Forest, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP 1560042 Issued in FL

Practice address

3129 Hendricks Avenue
Jacksonville, FL 32207-4217

Phone

(904) 398-8266

Fax

(904) 396-4803

NPI assigned

Oct 11, 2006

Last updated

Nov 22, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1912095233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3129 HENDRICKS AVENUE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074217",
            "telephone_number": "904-398-8266",
            "fax_number": "904-396-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3129 HENDRICKS AVENUE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074217",
            "telephone_number": "904-398-8266",
            "fax_number": "904-396-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMLEY-FOREST",
        "first_name": "ROY",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 1560042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul M Crum Jr., MD
• Deborah Jean Crumb, PHARM.D.
• Sierra Margaret Crumbaugh, PA
• Destiny Crumble
• Tierney A Crumbly
• John M. Crump, M. D.
• Natalie Lynn Crump
• James Edward Crumpton, FNP
• Betty J. Crusaw, ADMIN.OWNER
• Robert Martin Crutcher, MD

• Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.