Theodora Montell Cross, RN,MS,CNS,ANP-BC,CDE

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F304508 Issued in NY

Practice address

79 Cottage PL
Staten Island, NY 10302-1522

Phone

(718) 816-8423

Fax

(718) 816-5024

NPI assigned

Sep 5, 2008

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Master of Science, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

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.

• Island Nurse Practitioner in Family Health, PLLC

  • Family Nurse Practitioner
  • Staten Island, NY
  • NPI 1740593474
  NPD (past)

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1972751691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 COTTAGE PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021522",
            "telephone_number": "718-816-8423",
            "fax_number": "718-816-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 COTTAGE PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021522",
            "telephone_number": "718-816-8423",
            "fax_number": "718-816-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSS",
        "first_name": "THEODORA",
        "middle_name": "MONTELL",
        "name_prefix": "Ms.",
        "credential": "RN,MS,CNS,ANP-BC,CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-05",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F304508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adam Cropper
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• Crosstown Livery LLC (Village Car Service)
• Allison Crovo, LPN
• Crown Medical Supply Inc
• Crown Neurology, P.C.

• Adult Health Nurse Practitioner in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; 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.