Crockett Medical Clinic Inc - Medicare Primary Care in Alamo, TN

Crockett Medical Clinic Inc is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Alamo, Tennessee. The current practice location for Crockett Medical Clinic Inc is 58 S. Bells St, Alamo, Tennessee. For appointments, you can reach them via phone at (731) 696-5401. The mailing address for Crockett Medical Clinic Inc is 58 S. Bells St, Alamo, Tennessee and phone number is (731) 696-5401.

Crockett Medical Clinic Inc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1104839703. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (731) 696-5401.

Contact Information

Crockett Medical Clinic Inc
58 S. Bells St
Alamo
TN 38001
(731) 696-5401
(731) 696-5404

Primary Care Clinic Profile

Full NameCrockett Medical Clinic Inc
SpecialityClinic/Center
Location58 S. Bells St, Alamo, Tennessee
Authorized Official Name and PositionCharles Richard Jerman (CFO)
Authorized Official Contact7316964670
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Crockett Medical Clinic Inc
58 S. Bells St
Alamo
TN 38001

Ph: (731) 696-5401
Crockett Medical Clinic Inc
58 S. Bells St
Alamo
TN 38001

Ph: (731) 696-5401

NPI Details:

NPI Number1104839703
Provider Enumeration Date08/14/2006
Last Update Date07/02/2019

Medicare PECOS Information:

Medicare PECOS PAC ID8921009812
Medicare Enrollment IDO20070119000217

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Medical Identifiers

Medical identifiers for Crockett Medical Clinic Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104839703NPI-NPPES
3717707MedicaidTN
3717707OtherTNPTAN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Secondary
261QP2300XClinic/center - Primary Care (* (Not Available))Primary
363L00000XNurse Practitioner (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Crockett Medical Clinic Inc acts as a billing entity for following providers:
Provider NameRaymond W Rhear
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1659384253
PECOS PAC ID: 9436146370
Enrollment ID: I20040430000554

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Provider NameKaren E Webb
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902819501
PECOS PAC ID: 7517955446
Enrollment ID: I20040430001308

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Provider NameLori F Laman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1295906378
PECOS PAC ID: 5597844001
Enrollment ID: I20080509000046

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Provider NameDonna P Clement
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629272620
PECOS PAC ID: 8628145596
Enrollment ID: I20080917000833

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Provider NameKristin Byrd
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548569700
PECOS PAC ID: 2163609009
Enrollment ID: I20110602000260

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Provider NameLoren S Carroll
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1104168178
PECOS PAC ID: 0749409209
Enrollment ID: I20150421001883

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Provider NameSamantha French
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528698271
PECOS PAC ID: 2365870581
Enrollment ID: I20220209000240

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Provider NameMeredith Paige Gaitley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811634835
PECOS PAC ID: 5890171771
Enrollment ID: I20220929001961

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Clinic/Center in Alamo, TN

Alamo Family Medicine
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 157 N Bells St, Alamo, TN 38001
Phone: 731-696-5551    Fax: 731-696-2802

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