NPIMap

Organization Active NPI

Crockett Hospital LLC

  • Rural Health Clinic/Center
  • Loretto, TN
National Provider Identifier
1013574664
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CROCKETT HOSPITAL LLC
Practice address
722 N Military St
Loretto, TN 38469-2336
Phone
(931) 853-6970
Fax
(931) 853-6974
NPI assigned
May 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kathy Teague
Title
Secretary
Phone
(615) 920-7646

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

722 N Military St
Loretto, TN 38469-2336

Mailing address

330 Seven Springs Way
Atten: Provider Enrollment
Brentwood, TN 37027
Phone (615) 920-7782

Other names 1

  • Loretto Family Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern TN Regional4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558310400000",
    "number": "1013574664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "address_2": "ATTEN: PROVIDER ENROLLMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "37027",
            "telephone_number": "615-920-7782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 N MILITARY ST",
            "city": "LORETTO",
            "state": "TN",
            "postal_code": "384692336",
            "telephone_number": "931-853-6970",
            "fax_number": "931-853-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROCKETT HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-05-20",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7646"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loretto Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loretto, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.