Active NPI
Crockett Hospital LLC
- Rural Acute Care Hospital
- Lawrenceburg, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Acute Care Hospital
- License
- 0000000087
- Legal business name
- CROCKETT HOSPITAL LLC
- Practice address
- 1607 S Locust Ave
Lawrenceburg, TN 38464-4011 - Phone
- (931) 762-6571
- Fax
- (931) 766-3339
- NPI assigned
- Oct 31, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Terrance Dillon
- Title
- Assistant Secretary
- Phone
- (502) 596-7220
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Acute Care Hospital | 282NR1301X | 0000000087 | TN | Primary |
Addresses
Primary practice location
1607 S Locust Ave
Lawrenceburg, TN 38464-4011
Mailing address
330 Seven Springs Way
Brentwood, TN 37027-4536
Phone (615) 920-7000
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0440175 | Medicaid | TN | |
| HOS0175N | Medicaid | AL | |
| 000171091X | Medicaid | GA | |
| 1762067 | Medicaid | LA | |
| 09400008 | Medicaid | MS |
Other names 1
- Southern Tennessee Regional Health System Lawrenceburg
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | strhs-lawrenceburg@yourcarecommunity.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040814000037 | TN | Part A Provider - Hospital | 7810960226 | Practice locations: Lawrenceburg, TN |
Hospital certification: CCN 440175
- Legal name
- CROCKETT HOSPITAL LLC
- Doing business as
- SOUTHERN TENNESSEE REGIONAL HEALTH SYSTEM LAWRENCEBURG
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jan 28, 1974
- Last certification
- Jul 11, 2018
- Beds
- 96
- Ownership / control type
- Other
- Most recent change of ownership
- Feb 1, 1999 (1 total)
- Organization structure
- LLC
- Incorporated
- Nov 9, 1998 in DE
- Enrollment address
- 1607 S Locust Ave
Lawrenceburg, TN 38464-4011 - Hospital subgroups
- Acute care, Rehabilitation
Related certifications (CCN) 2
Facilities connected through Provider of Services related, parent or unit certification numbers.
-
- Medicare Defined Swing Bed Hospital Unit
- Lawrenceburg, TN
- NPI 1720212038
Hospital unit
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Medicare Defined Swing Bed Hospital Unit
- Lawrenceburg, TN
- NPI 1720212038
7810960226
Care Compare: Hospital
Medicare Care Compare- Listed as
- Southern Tennessee Regional Health System Lawrence
- Overall star rating
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Other
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider Directory- Tax ID family
- Southern TN Regional
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Rural Health Clinic/Center
- Loretto, TN
- NPI 1013574664
-
- Rehabilitation Hospital Unit
- Lawrenceburg, TN
- NPI 1790864288
-
- Medicare Defined Swing Bed Hospital Unit
- Lawrenceburg, TN
- NPI 1720212038
Ownership & related parties
All disclosed owners & managing parties 14
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Lifepoint Holdings 2 LLC | 5% Or Greater Direct Ownership Interest | Jan 31, 1999 | 100% |
| Lifepoint Corporate Services General Partnership | Operational/Managerial Control | Jan 1, 2015 | |
| William Haugh | Corporate Officer | Jan 25, 2022 | |
| DSB Acquisition LLC | 5% Or Greater Indirect Ownership Interest | Nov 16, 2018 | 100% |
| Lifepoint Hospitals Holdings LLC | 5% Or Greater Indirect Ownership Interest | Feb 1, 1999 | 100% |
| Historic Lifepoint Hospitals, LLC | 5% Or Greater Indirect Ownership Interest | Feb 1, 1999 | 100% |
| Daniel Davis | Corporate Officer | Jun 24, 2019 | |
| Lifepoint Health Inc | 5% Or Greater Indirect Ownership Interest | Nov 16, 2018 | 100% |
| Marcus B Poppell | Corporate Officer | Nov 2, 2009 | |
| Other | Feb 1, 1999 | ||
| Charlotte E Lawrence | Corporate Officer | Jan 25, 2022 | |
| Eric Rhee Perry | Operational/Managerial Control | Jan 6, 2025 | |
| John Michael Grooms | Corporate Officer | Nov 1, 2016 | |
| Christopher J Monte | Corporate Officer | Jul 27, 2005 | |
| Legacy Lifepoint Health LLC | 5% Or Greater Indirect Ownership Interest | Feb 24, 2022 | 100% |
Facilities with the same owner 195
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Rural Health Clinic/Center
- Mt Pleasant, TN
- NPI 1255069639
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
- Rural Health Clinic/Center
- Lawrenceburg, TN
- NPI 1023840998
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
- Rural Health Clinic/Center
- Lawrenceburg, TN
- NPI 1417739640
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
- Rural Health Clinic/Center
- Loretto, TN
- NPI 1811543929
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
- Rural Health Clinic/Center
- Lawrenceburg, TN
- NPI 1891580858
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
- Rural Health Clinic/Center
- Pulaski, TN
- NPI 1063294296
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
- Rural Health Clinic/Center
- Pulaski, TN
- NPI 1144052002
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
- Rural Health Clinic/Center
- Lynnville, TN
- NPI 1407688369
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
- Rural Health Clinic/Center
- Ardmore, TN
- NPI 1558117028
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
- Rural Health Clinic/Center
- Pulaski, TN
- NPI 1568190551
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
- Rural Health Clinic/Center
- Lewisburg, TN
- NPI 1881426740
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
- Rural Health Clinic/Center
- Winchester, TN
- NPI 1063140051
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Pulaski, TN
- NPI 1215165311
-
- Hospitalist Physician
- Knoxville, TN
- NPI 1922036961
-
- Advanced Practice Midwife
- Pulaski, TN
- NPI 1801068010
-
- Family Medicine Physician
- Lawrenceburg, TN
- NPI 1134195860
-
- Family Medicine Physician
- Loretto, TN
- NPI 1427096262
-
- Pediatrics Physician
- Nashville, TN
- NPI 1639168016
-
- Hospitalist Physician
- Canton, MI
- NPI 1093905226
Affiliated clinicians 184
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1650931200000",
"number": "1114003175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 SEVEN SPRINGS WAY",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370274536",
"telephone_number": "615-920-7000",
"fax_number": "615-920-8913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1607 S LOCUST AVE",
"city": "LAWRENCEBURG",
"state": "TN",
"postal_code": "384644011",
"telephone_number": "931-762-6571",
"fax_number": "931-766-3339"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CROCKETT HOSPITAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-31",
"last_updated": "2022-04-26",
"certification_date": "2022-04-26",
"status": "A",
"authorized_official_last_name": "DILLON",
"authorized_official_first_name": "TERRANCE",
"authorized_official_title_or_position": "ASSISTANT SECRETARY",
"authorized_official_telephone_number": "502-596-7220"
},
"taxonomies": [
{
"code": "282NR1301X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital, Rural",
"state": "TN",
"license": "0000000087",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0440175",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "HOS0175N",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000171091X",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1762067",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09400008",
"state": "MS"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "strhs-lawrenceburg@yourcarecommunity.org",
"affiliation": "N",
"address_1": "1607 S Locust Ave",
"city": "Lawrenceburg",
"state": "TN",
"country_code": "US",
"postal_code": "384644011",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Southern Tennessee Regional Health System Lawrenceburg",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Southern Tennessee Regional Health System Lawrenceburg",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lawrenceburg, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.