Timothy Ray Crossett, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

19952 Issued in TN

Practice address

620 Skyline Drive
Jackson, TN 38301-3901

Phone

(731) 541-6174

Fax

(731) 425-6274

NPI assigned

Mar 2, 2006

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jackson Radiology Associates PA

  • Diagnostic Radiology Physician
  • Jackson, TN
  • NPI 1699700716

  Diagnostic Radiology, TN

  Medicare reassignment NPD
• Professional Imaging of Tennessee

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Somerville, TN
  • NPI 1073569901
  NPD
• Bolivar General Hospital, Inc.

  • General Acute Care Hospital
  • Bolivar, TN
  • NPI 1174545446
  NPD (past)
• Bolivar General Hospital, Inc.

  • Critical Access Hospital
  • Bolivar, TN
  • NPI 1518957950
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 25, 2017.

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1023085628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11955",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383080132",
            "telephone_number": "731-541-5000",
            "fax_number": "614-210-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DRIVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013901",
            "telephone_number": "731-541-6174",
            "fax_number": "731-425-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSETT",
        "first_name": "TIMOTHY",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "19952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3058645",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4102190",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3086620",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00271014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "300056937",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "300056951",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3086628",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3828137",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jimmy Crosnoe, PT
• Alvin Scott Cross, D.D.S.
• John Adrian Cross, D.PH.
• Crystal D Crosser, APNP
• Hannah L Crossett, LPC
• Crossroads Urgent Care, PLLC
• Mary Ann Crouse
• John Walton Crowder, D.D.S.
• Justin Edward Crowder, M.ED.
• Lindsey Crowder

• All providers in Jackson, TN
• Diagnostic Radiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.