MS. OCTAVIA G. CROOKS (NPI# 1407400922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407400922 |
| Entity Type | Individual |
| Full Name | MS. OCTAVIA G. CROOKS |
| Credential | LPN |
| Practice Address |
4024 Central Ave St Petersburg FL 33711-1239 |
| Mailing Address |
Po Box 10970 St Petersburg FL 33733-0970 |
| Practice Telephone | 7273277656 |
| Practice Fax Number | 7273222110 |
| Mailing Telephone | 7273277656 |
| Mailing Fax Number | 7273222110 |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | PN5236171 | FL | Nursing Service Providers |
| Street Address |
4024 CENTRAL AVE |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33711-1239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659371763 | Suncoast Center, Inc. | Clinic/Center | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2005-07-29 |
| 1790384709 | Tracy Reenae Hardaway | Counselor | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-10-21 |
| 1154928877 | Tyler Ray-baker | Counselor | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-10-06 |
| 1720694565 | Meghan Reese | Counselor | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-09-17 |
| 1720691595 | Georgette Franklin | Case Manager/Care Coordinator | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-08-31 |
| 1518570381 | Stephanie Ganoe | Counselor | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-08-31 |
| 1679181655 | April Irwin | Counselor | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-07-16 |
| 1497373757 | Mishania Jenkins | Case Manager/Care Coordinator | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-07-13 |
| 1154945632 | Kenneth Westerfield | Behavioral Analyst | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-06-01 |
| 1235753674 | Kathryn Ann Pinkston | Registered Nurse | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2020-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639665110 | Armando Alvarez Gonzalez | Nurse Practitioner | 3404 26th Ave S, St Petersburg, FL 33711 | 2018-07-08 |
| 1508398843 | S&r Cares LLC | Preferred Provider Organization | 4201 4th Avenue South Street, St Petersburg, FL 33711 | 2017-03-28 |
| 1245691062 | Brian Paulson | Counselor | 4024 Central Ave # 1239, Saint Petersburg, FL 33711 | 2016-03-08 |
| 1871966069 | Kelly Jean Plant | Home Health Aide | 3611 3rd Ave South, St Petersburg, FL 33711 | 2015-11-10 |
| 1750784815 | Honor Investments LLC | Community/Behavioral Health | 4750 Dophin Cay Ln S, #508, St Petersburg, FL 33711 | 2014-10-03 |
| 1063771947 | Vincent Ford | Physical Therapy Assistant | 3479 22nd Avenue, St.petersburg, FL 33711 | 2012-05-11 |
| 1568758571 | Ashley Lauren Taliaferro | Physical Therapist | 5042 42nd St S, Saint Petersburg, FL 33711 | 2011-06-28 |
| 1801180187 | Karen Lynn Wilcox | Massage Therapist | 2026 44th Street S, Saint Petersburg, FL 33711 | 2011-06-04 |
| 1881998722 | Martha L Allen | Assisted Living Facility | 1860 46 Street South, St. Petersburg, FL 33711 | 2011-01-07 |
| 1760519052 | Scg Palazzo Operator, LLC | Assisted Living Facility | 3600 34th St South, St Augustine, FL 33711 | 2007-02-27 |
| Find all providers in zip 33711 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043601586 | Lorraine Sorrick | Licensed Practical Nurse | 10182 12th Way N Apt 107, St Petersburg, FL 33716-4363 | 2015-02-05 |
| 1487052148 | Brock and Harrison Services, LLC | Licensed Practical Nurse | 3344 23rd St N, St Petersburg, FL 33713-2708 | 2014-12-12 |
| 1811318116 | Alberto Casas | Licensed Practical Nurse | 6217 38th Ave N, St Petersburg, FL 33710-1608 | 2014-01-04 |
| 1215368279 | Stephanie Carrington | Licensed Practical Nurse | 3110 1st Ave N Ste 2i, St Petersburg, FL 33713-8637 | 2013-12-02 |
| 1063793578 | Raphael Sanders | Licensed Practical Nurse | 11150 4th St N, #4502, St Petersburg, FL 33716-2914 | 2011-08-30 |
| 1568796985 | Superior Staffing | Licensed Practical Nurse | 6190 80th St N Apt 104, St Petersburg, FL 33709-1069 | 2009-10-02 |
| 1881852226 | Sheron Angela Bygraves | Licensed Practical Nurse | 6425 Canton St S, St Petersburg, FL 33712-5560 | 2008-05-31 |
| 1922276450 | Eric Gerard Hicks | Licensed Practical Nurse | 7251 Cedar Ct N Apt 207, St Petersburg, FL 33702-5545 | 2008-02-19 |
| 1841409679 | Karen Sue Cary Lentz | Licensed Practical Nurse | 1099 5th Ave N, Suite 110, St Petersburg, FL 33705-1469 | 2007-05-21 |
| 1114072790 | Maryann Ralston | Licensed Practical Nurse | 4820 Venetian Blvd Ne, St Petersburg, FL 33703-4228 | 2007-01-24 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33711 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.