AMG CROCKETT LLC (NPI# 1013374073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013374073 |
| Entity Type | Organization |
| Organization Name | AMG CROCKETT LLC |
| Other Organization Name | SOUTHERN TENNESSEE HEART |
| Practice Address |
1611 S Locust Ave Suite 200b Lawrenceburg TN 38464-4055 |
| Practice Telephone | 9317663684 |
| Mailing Telephone | 9317663684 |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |
| Authorized Official Name | CASEY J. WILLIS (MARKET MANAGER) |
| Authorized Official Telephone | 9317664574 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SOUTHERN TENNESSEE HEART | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063802767 | Amg Crockett LLC | Nurse Practitioner | 1908 N Locust Ave, Lawrenceburg, TN 38464-2334 | 2015-02-02 |
| 1316349764 | Amg Crockett LLC | Family Medicine | 4955 Highway 43 N, Mount Pleasant, TN 38474-5010 | 2014-09-17 |
| 1730511858 | Amg Crockett LLC | Family Medicine | 550 Highway 64 E, Hurricane Plaza Suite 4, Waynesboro, TN 38485-3037 | 2013-07-31 |
| 1659514776 | Amg Crockett LLC | Family Medicine | 106 S Military Ave, Loretto, TN 38469-2101 | 2009-04-20 |
| 1326550732 | Amg Crockett LLC | Pediatrics | 1908 N Locust Ave, Lawrenceburg, TN 38464-2334 | 2017-10-26 |
| 1881103810 | Amg Crockett LLC | Urology | 190 Prosser Rd, Lawrenceburg, TN 38464-4233 | 2017-09-21 |
| 1952780454 | Amg Crockett LLC | Family Medicine | 1009 N Locust Ave, Lawrenceburg, TN 38464-2746 | 2015-05-29 |
| 1245634021 | Amg Crockett LLC | Internal Medicine | 1323 S Locust Ave, Lawrenceburg, TN 38464-4040 | 2014-10-22 |
| 1457666372 | Amg Crockett LLC | Orthopaedic Surgery | 1605 S Locust Ave, Suite 101, Lawrenceburg, TN 38464-4061 | 2010-08-16 |
| 1851531693 | Amg Crockett LLC | Family Medicine | 184 Prosser Rd, Lawrenceburg, TN 38464-4233 | 2009-03-05 |
| Street Address |
1611 S LOCUST AVE SUITE 200B |
| City | LAWRENCEBURG |
| State | TN |
| Zip Code | 38464-4055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265099782 | Yolande P Parson | Social Worker | 1236 1st Ave, Lawrenceburg, TN 38464 | 2019-05-20 |
| 1457878928 | Sheila Ann Turpen | Occupational Therapist | 2380 Buffalo Road, Lawrenceburg, TN 38464 | 2017-08-25 |
| 1790035863 | Donna Cheryll Collins | Nurse Practitioner | 129 South Locust Ave, Lawerenceburg, TN 38464 | 2012-09-14 |
| 1548558943 | John T. Will, D.d.s. | Dentist | 234 East Gaines St, Lawrenceburg, TN 38464 | 2011-07-19 |
| 1093008476 | James Lawson Sullenger | Pharmacist | 2201 North Locust Ave, Lawrenceburg, TN 38464 | 2011-05-18 |
| 1346412624 | Respi-care Inc. | Durable Medical Equipment & Medical Supplies | 14 Public Square, Lawrenceburg, TN 38464 | 2008-03-27 |
| 1215144936 | Amg-crockett, LLC | Urology | Us Highway 43 South, Lawrenceburg, TN 38464 | 2007-05-16 |
| 1548472715 | Lawrence County Senior Citizens Club Inc | Non-emergency Medical Transport (VAN) | 220 Centennial Blvd., Lawrenceburg, TN 38464 | 2007-05-03 |
| 1316169345 | Bernard T Beuerlein | Pharmacist | 111 North Columbia Ave, Lawrenceburg, TN 38464 | 2007-05-02 |
| 1528289188 | Richard Dean Jennings | Pharmacist | 11 Public Square, Lawrenceburg, TN 38464 | 2007-05-01 |
| Find all providers in zip 38464 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669471322 | Ashok Penmetsa | Internal Medicine | 606 Wilson Creek Rd, Suite 410, Lawrenceburg, IN 47025-1095 | 2005-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935437 | Cvc Pllc | Internal Medicine | 22 Deepwood Dr, Jackson, TN 38305-9679 | 2020-06-02 |
| 1073085189 | Heart Center Usa Incorporated | Internal Medicine | 6500 Kirby Gate Blvd, Memphis, TN 38119-2673 | 2018-12-31 |
| 1700357035 | Morristown Heart, Pllc | Internal Medicine | Morristown Heart, Pllc, 735 Mcfarland Street, Morristown, TN 37814 | 2018-12-16 |
| 1902353444 | Hh Physician Care-elkton Tennessee | Internal Medicine | 1446 Bryson Road, Ardmore, TN 38449 | 2016-09-01 |
| 1902352750 | Rose Marie Robertson | Internal Medicine | 4003 Newman Pl, Nashville, TN 37204-4308 | 2016-08-31 |
| 1821488727 | Bruce Wilson Md PC | Internal Medicine | 5885 Airline Rd, # 985, Arlington, TN 38002-5127 | 2015-01-29 |
| 1982013215 | Blue Ridge Medical Management Corporation | Internal Medicine | 1901 S Shady St Ste 1, Mountain City, TN 37683-2021 | 2014-08-12 |
| 1871835892 | Robert Maxwell Smith | Internal Medicine | 1004 Deep Woods Trl, Brentwood, TN 37027-6309 | 2013-03-18 |
| 1750630794 | David Marc Mirvis | Internal Medicine | 5676 Redding Ave, Memphis, TN 38120-1848 | 2012-09-06 |
| 1255607164 | Dmitry M Yaranov | Internal Medicine | 6025 Walnut Grove Rd Ste 111, Memphis, TN 38120-2102 | 2012-03-25 |
| Find all providers with the same taxonomy | ||||
| City | LAWRENCEBURG |
| Zip Code | 38464 |
Please comment or provide details below to improve the information on AMG CROCKETT LLC.
| 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.