Individual provider Active NPI

Rose M Crenshaw-Corley

  • Social Worker
  • Newark, NJ
National Provider Identifier
1952730996
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SW04710500 Issued in NJ
Practice address
45 Lehigh Ave
Newark, NJ 07112-2503
Phone
(973) 923-3755
Fax
(973) 923-3755
NPI assigned
Nov 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SW04710500 NJ Primary

Addresses

Primary practice location

45 Lehigh Ave
Newark, NJ 07112-2503

Mailing address

45 Lehigh Ave
Newark, NJ 07112-2503
Phone (973) 923-3755

Other names 1

  • Rose M Crenshaw Former name

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
44SW04710500NJMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1952730996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 LEHIGH AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122503",
            "telephone_number": "973-923-3755",
            "fax_number": "973-923-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 LEHIGH AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122503",
            "telephone_number": "973-923-3755",
            "fax_number": "973-923-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRENSHAW-CORLEY",
        "first_name": "ROSE",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SW04710500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSE",
            "last_name": "CRENSHAW",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.