AMG-CROCKETT, LLC (NPI# 1811543929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811543929 |
| Entity Type | Organization |
| Organization Name | AMG-CROCKETT, LLC |
| Other Organization Name | FIRST CHOICE HEALTH LORETTO |
| Practice Address |
722 N Military St Loretto TN 38469-2336 |
| Mailing Address |
330 Seven Springs Way Atten: Provider Enrollment Brentwood TN 37027-5098 |
| Practice Telephone | 9318536970 |
| Practice Fax Number | 9318536974 |
| Mailing Telephone | 6159207782 |
| Mailing Fax Number | 6159208775 |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2020-08-26 |
| Authorized Official Name | KATHY TEAGUE (CORPORATE SECRETARY) |
| Authorized Official Telephone | 6159207646 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| First Choice Health Loretto | Doing Business As Name - Organization |
| Loretto Family Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215144936 | Amg-crockett, LLC | Urology | Us Highway 43 South, Lawrenceburg, TN 38464 | 2007-05-16 |
| 1144593658 | Amg-crockett, LLC | Obstetrics & Gynecology | 1605 S Locust Ave, Suite 200, Lawrenceburg, TN 38464-4061 | 2012-02-14 |
| 1578836011 | Amg-crockett, LLC | Surgery | 1605 S Locust Ave, Suite 201, Lawrenceburg, TN 38464-4061 | 2012-02-14 |
| 1043475700 | Amg-crockett, LLC | Psychiatry & Neurology | 1605 S Locust Ave, Suite 103, Lawrenceburg, TN 38464-4053 | 2008-07-22 |
| 1689843153 | Amg-crockett, LLC | Family Medicine | 184 Prosser Rd, Lawrenceburg, TN 38464-4233 | 2008-02-28 |
| 1912125600 | Amg-crockett, LLC | Urology | 1605 S Locust Ave, Suite 103, Lawrenceburg, TN 38464-4053 | 2007-04-20 |
| Street Address |
722 N MILITARY ST |
| City | LORETTO |
| State | TN |
| Zip Code | 38469-2336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538576970 | Ecm Health Group LLC | Internal Medicine | 722 N Military St, Loretto, TN 38469-2336 | 2014-07-17 |
| 1013574664 | Crockett Hospital LLC | Family Medicine | 722 N Military St, Loretto, TN 38469-2336 | 2019-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982993473 | Kimberly Lane Johnson | Social Worker | 161 Fleming Road, Loretto, TN 38469 | 2011-04-05 |
| 1891753117 | Rufus G Harmon | Pharmacist | 534 N Military St, Loretto, TN 38469 | 2006-05-03 |
| 1790756724 | Gail Yvonne Kase | Psychiatry & Neurology | Bldg. 52 Lake Drive, Va Medical Center, Mountain Home, TN 38469 | 2006-01-28 |
| 1174522007 | Emily V Gillespie | Nurse Practitioner | 722 N. Military Ave., Loretto, TN 38469 | 2005-07-21 |
| 1730565789 | Jeffrey H Hernandez | Nurse Practitioner | 106 S Military St, Loretto, TN 38469-2100 | 2015-07-31 |
| 1932610367 | Nikki Lee Davenport | Nurse Practitioner | 106 S Military St, Loretto, TN 38469-2100 | 2017-10-12 |
| 1235687807 | Mona Olive | Nurse Practitioner | 106 S Military St, Loretto, TN 38469-2100 | 2016-09-13 |
| 1366080582 | Matthew E. Schantz, M.d. | Clinic/Center | 206 S Military St Ste 1, Loretto, TN 38469-2101 | 2019-12-18 |
| 1659514776 | Amg Crockett LLC | Family Medicine | 106 S Military Ave, Loretto, TN 38469-2101 | 2009-04-20 |
| 1427096262 | Matthew E. Schantz | Family Medicine | 206 S Military St, Loretto, TN 38469-2101 | 2006-06-03 |
| Find all providers in zip 38469 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164887253 | Ecm Health Group LLC | Clinic/Center | 722 N Miliary St, Loretto, TN 38469-2336 | 2015-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588275317 | Henry County Medical Center | Clinic/Center | 300 Hospital Cir Ste 204, Paris, TN 38242-4597 | 2020-08-14 |
| 1447861562 | Henry County Medical Center | Clinic/Center | 14201 Highway 79 N Unit 4, Buchanan, TN 38222-4183 | 2020-08-12 |
| 1003425224 | Dickson Medical Associate, PC | Clinic/Center | 127 Crestview Park Dr Ste 205, Dickson, TN 37055-2856 | 2020-07-23 |
| 1023631454 | Spring City Family Clinic Pllc | Clinic/Center | 126 Lavender St Ste 2, Spring City, TN 37381-5102 | 2020-05-20 |
| 1871001271 | Shelbyville Hospital Company LLC | Clinic/Center | 1330 Cedar Ln Ste 100, Tullahoma, TN 37388-2284 | 2018-01-19 |
| 1720596125 | Shelbyville Hospital Company LLC | Clinic/Center | 1440 Cedar Ln Unit 100, Tullahoma, TN 37388-2262 | 2018-01-19 |
| 1548788458 | Shelbyville Hospital Company LLC | Clinic/Center | 1612 N Main St Ste A, Shelbyville, TN 37160-2392 | 2017-08-31 |
| 1063938520 | Mid-south Convenient Care, Pllc | Clinic/Center | 1445 Us Highway 51 Byp E Ste B, Dyersburg, TN 38024-2127 | 2017-08-16 |
| 1871034462 | Martin Health | Clinic/Center | 143 Kennedy Drive, Martin, TN 38237-3309 | 2017-03-15 |
| 1881135895 | Humboldt Family Walk-in Clinic LLC | Clinic/Center | 1600 Coleman Dr, Humboldt, TN 38343-1756 | 2017-03-10 |
| Find all providers with the same taxonomy | ||||
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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.