DR. MICHELE MARIE CROCKETT (NPI# 1134139983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134139983 |
| Entity Type | Individual |
| Full Name | DR. MICHELE MARIE CROCKETT |
| Credential | MD |
| Practice Address |
5002 Cowhorn Creek Rd Texarkana TX 75503-9766 |
| Practice Telephone | 9036143000 |
| Mailing Telephone | 9036143000 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2008-06-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD.200782 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5901422 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265773238 | Michele Marie Crockett | Registered Nurse | 100 Blassingame Rd, Greenville, SC 29605-3304 | 2013-03-15 |
| Street Address |
5002 COWHORN CREEK RD |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75503-9766 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447255229 | Jeffrey David Decaprio | Surgery | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-06-17 |
| 1225681604 | Lauren N. Hadaway | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2019-07-24 |
| 1144872839 | Brandi M. Martin | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2019-07-12 |
| 1093292104 | Heidi R Smith | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-07-20 |
| 1194215814 | Angela L Bowen | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-05-17 |
| 1689174955 | Cody C Ray | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-02-13 |
| 1699282087 | Melissa Ann Lamon | Registered Nurse | 5002 Cowhorn Creek Rd, Texarkana, TX 75503 | 2018-01-07 |
| 1013443589 | Laura L Jackson | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-05-03 |
| 1316478852 | Schamma Salomon | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-03-26 |
| 1346781325 | Melissa Elizabeth Redfearn | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-03-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1821583501 | Brandy D Acker | Psychologist | 3615 Richmond Rd, Texarkana, TX 75503 | 2018-06-26 |
| 1366935066 | Samantha Lee Harris | Nurse Practitioner | 4116 Mcknight Rd, Texarkana, TX 75503 | 2018-06-07 |
| 1811416910 | Heather Alison Gerber | Nurse Practitioner | 5903 Brenda Street, Texarkana, TX 75503 | 2017-09-11 |
| 1952838682 | John Kyle Abney | Counselor | 4134 Mcknight Rd, Texarkana, TX 75503 | 2017-05-12 |
| 1699151514 | Piney Woods Er IIi LLC | Clinic/Center | 4102 Gibson Lane, Texarkana, TX 75503 | 2015-08-03 |
| 1609282433 | Colby Rebecca Pair | Physician Assistant | 2604 St. Michael Dr., Suite 310, Texarkana, TX 75503 | 2014-07-01 |
| 1265842496 | Healthcare Express, LLP | Clinic/Center | 3513 Richmond Rd, Texarkana, TX 75503 | 2014-04-28 |
| 1134540628 | Eagle Dental Center of Texarkana Pllc | Dentist | 4009 Moores Ln, Texarkana, TX 75503 | 2013-12-30 |
| 1326481664 | Juancarlo S. Pascual | Family Medicine | 604 St. Michael Dr, Suite 340, Texarkana, TX 75503 | 2013-04-16 |
| Find all providers in zip 75503 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346356573 | Medical Investments of Texarkana LLC | Radiology | 4303 Texas Blvd Ste 8, Texarkana, TX 75503-3094 | 2006-08-21 |
| 1588770721 | Texarkana Mri, Lp | Radiology | 4303 Texas Blvd # No.8, Texarkana, TX 75503-3097 | 2006-08-21 |
| 1912994708 | Larry M Peebles | Radiology | 4102 Richmond Mdws, Texarkana, TX 75503-0067 | 2005-10-05 |
| 1245231885 | William Randall Brown | Radiology | 5508 Summerhill Rd, Texarkana, TX 75503-1822 | 2005-08-04 |
| 1225637820 | Photon Imaging, Pllc | Radiology | 515 W 12th St, Texarkana, TX 75501-4416 | 2020-10-23 |
| 1235503319 | William Beaty | Radiology | 5508 Summerhill Rd, Texarkana, TX 75503-1822 | 2015-11-30 |
| 1548681042 | Samuel Thomas Gatzert | Radiology | 2600 Saint Michael Dr, Texarkana, TX 75503-2372 | 2013-12-31 |
| 1124286737 | Joshua Gordon Martin | Radiology | 4102 Richmond Mdws, Texarkana, TX 75503-0067 | 2008-05-30 |
| 1609049956 | Robert Samuel Mcginnis IIi | Radiology | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2008-04-08 |
| 1437320256 | Christian Allen Sell | Radiology | 4102 Richmond Mdws, Texarkana, TX 75503-0067 | 2008-03-19 |
| Find all providers in TEXARKANA | ||||
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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.