Jared M Crocker (NPI# 1114442324, PAC ID# 4284974726) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA).
| Nation Provider ID (NPI) | 1114442324 |
| PAC ID by PECOS | 4284974726 |
| Professional Enrollment ID | I20190320002596 |
| Full Name | Jared M Crocker |
| Organization Legal Name | EXCEL ANESTHESIA PSC |
| Address |
910 Wallace Ave Leitchfield KY 42754-2414 |
| Phone Number | 2702599512 |
| Gender | M |
| Graduation Year | 2017 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| Group Practice PAC ID | 8628973310 |
| Number of Group Practice Members | 17 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180070 | TWIN LAKES REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 910 Wallace Ave, Leitchfield, KY 42754-2414 | 2702599512 | EXCEL ANESTHESIA PSC |
| Organization Legal Name | EXCEL ANESTHESIA PSC |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Lyons | Certified Registered Nurse Anesthetist (crna) | Excel Anesthesia Psc | 1211 Main St, Hartford, KY 42347-1619 |
| Ross W Cotton | Anesthesiology | Excel Anesthesia Psc | 1211 Main St, Hartford, KY 42347-1619 |
| Kimberly Covington | Certified Registered Nurse Anesthetist (crna) | Excel Anesthesia Psc | 1211 Main St, Hartford, KY 42347-1619 |
| Lisa G Pagel | Certified Registered Nurse Anesthetist (crna) | Excel Anesthesia Psc | 440 Hopkinsville St, Greenville, KY 42345-1124 |
| Melissa Gail Fitch | Certified Registered Nurse Anesthetist (crna) | Excel Anesthesia Psc | 440 Hopkinsville St, Greenville, KY 42345-1124 |
| John A Gaither | Certified Registered Nurse Anesthetist (crna) | Excel Anesthesia Psc | 1211 Main St, Hartford, KY 42347-1619 |
| Jeffrey K Jenkins | Certified Registered Nurse Anesthetist (crna) | Excel Anesthesia Psc | 1211 Main St, Hartford, KY 42347-1619 |
| Kristen Arbuckle | Certified Registered Nurse Anesthetist (crna) | Excel Anesthesia Psc | 440 Hopkinsville St, Greenville, KY 42345-1124 |
| Terry L Sweatt | Certified Registered Nurse Anesthetist (crna) | Excel Anesthesia Psc | 440 Hopkinsville St, Greenville, KY 42345-1124 |
| Ginger R Waldron | Certified Registered Nurse Anesthetist (crna) | Excel Anesthesia Psc | 1211 Main St, Hartford, KY 42347-1619 |
| Street Address |
910 WALLACE AVE |
| City | LEITCHFIELD |
| State | KY |
| Zip | 42754-2414 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christina M Wills | Nurse Practitioner | Concord Company of Tennessee Pllc | 910 Wallace Ave, Leitchfield, KY 42754-2414 |
| Luke Portwood Fife | General Surgery | Twin Lakes Medical Foundation Inc | 910 Wallace Ave, Leitchfield, KY 42754-2414 |
| Clinton Kaufman | General Surgery | Twin Lakes Medical Foundation Inc | 910 Wallace Ave, Leitchfield, KY 42754-2414 |
| Andrew Jenkins | Family Medicine | 910 Wallace Ave, Leitchfield, KY 42754-2414 | |
| James S Buck | Obstetrics/gynecology | Twin Lakes Medical Foundation Inc | 910 Wallace Ave, Leitchfield, KY 42754-2414 |
| Todd A Wical | Family Medicine | Concord Company of Tennessee Pllc | 910 Wallace Ave, Leitchfield, KY 42754-2414 |
| Hani A Bleibel | Internal Medicine | 910 Wallace Ave, Leitchfield, KY 42754-2414 | |
| Kimberly E Gowin | Nurse Practitioner | Twin Lakes Medical Foundation Inc | 910 Wallace Ave, Leitchfield, KY 42754-2414 |
| George O Nobile | Emergency Medicine | Concord Company of Tennessee Pllc | 910 Wallace Ave, Leitchfield, KY 42754-2414 |
| Charles D Jarboe | Family Medicine | Concord Company of Tennessee Pllc | 910 Wallace Ave, Leitchfield, KY 42754-2414 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Erica Patton Simpson | Clinical Social Worker | Associates In Counseling | 48 Public Sq, Leitchfield, KY 42754-1105 |
| Michael L Walker | Chiropractic | Walker Chiropractic Inc | 113 W Main St, Leitchfield, KY 42754-1149 |
| Jeffrey N Been | Orthopedic Surgery | Pt Pros Inc | 201 S Main St, Leitchfield, KY 42754-1425 |
| Spencer D Fuehne | Physical Therapy | Pt Pros Inc | 201 S Main St, Leitchfield, KY 42754-1425 |
| Isaac Miller | Sports Medicine | Pt Pros Inc | 201 S Main St, Leitchfield, KY 42754-1425 |
| Craig A Johnson | Internal Medicine | Pt Pros Inc | 201 S Main St, Leitchfield, KY 42754-1425 |
| Ted Benjamin Rogers | Orthopedic Surgery | Pt Pros Inc | 201 S Main St, Leitchfield, KY 42754-1425 |
| Bryce A. Meredith | Family Medicine | Pt Pros Inc | 201 S Main St, Leitchfield, KY 42754-1425 |
| Rita A Logsdon | Nurse Practitioner | Pt Pros Inc | 201 S Main St, Leitchfield, KY 42754-1425 |
| Cari Beth Johnson | Nurse Practitioner | Pt Pros Inc | 201 S Main St, Leitchfield, KY 42754-1425 |
| Find all physicians in zip 42754 | |||
| City | LEITCHFIELD |
| Zip Code | 42754 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| City + Specialty | LEITCHFIELD + CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
Please comment or provide details below to improve the information on Jared M Crocker.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.