Active NPI
Crickett Renee Maddox, RN
- Registered Nurse
- Valley, WA
National Provider Identifier
1962932152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN60354027
- Practice address
- 4121 Hesseltine Rd
Valley, WA 99181-9646 - Phone
- (509) 380-7043
- NPI assigned
- Jun 19, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN60354027 | WA | Primary |
Addresses
Primary practice location
4121 Hesseltine Rd
Valley, WA 99181-9646
Mailing address
4121 Hesseltine Rd
Valley, WA 99181-9646
Phone (509) 380-7043
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MADDOCR208LQ | Other | WA | DRIVER'S LICENSE |
| RN60354027 | Other | WA | REGISTERED NURSE |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN60354027 | WA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497830400000",
"number": "1962932152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4121 HESSELTINE RD",
"city": "VALLEY",
"state": "WA",
"postal_code": "991819646",
"telephone_number": "509-380-7043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4121 HESSELTINE RD",
"city": "VALLEY",
"state": "WA",
"postal_code": "991819646",
"telephone_number": "509-380-7043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDOX",
"first_name": "CRICKETT",
"middle_name": "RENEE",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-19",
"last_updated": "2017-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN60354027",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "MADDOCR208LQ",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED NURSE",
"identifier": "RN60354027",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.