Active NPI
Corrie Crump, ACNPC-AG
- Nurse Practitioner
- Medford, OR
National Provider Identifier
1992524201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 202112389NP-PP
- Practice address
- 2900 State St
Medford, OR 97504-8458 - Phone
- (541) 779-1672
- NPI assigned
- Oct 4, 2024
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 202112389NP-PP | OR | Primary |
Addresses
Primary practice location
2900 State St
Medford, OR 97504-8458
Mailing address
3457 Durst St
Medford, OR 97504-4221
Phone (330) 501-0444
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
| License | State | Type | Specialty |
|---|---|---|---|
| 202112389NP-PP | OR | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728000000000",
"number": "1992524201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3457 DURST ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975044221",
"telephone_number": "330-501-0444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 STATE ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975048458",
"telephone_number": "541-779-1672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUMP",
"first_name": "CORRIE",
"credential": "ACNPC-AG",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-04",
"last_updated": "2024-10-04",
"certification_date": "2024-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OR",
"license": "202112389NP-PP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.