Active NPI
Damita Crockett
- Non-emergency Medical Transport (VAN)
- Memphis, TN
National Provider Identifier
1154881191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Non-emergency Medical Transport (VAN)
- Practice address
- 1768 Keltner Cir Apt 4
Memphis, TN 38114-4664 - Phone
- (901) 596-9911
- NPI assigned
- Mar 25, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-emergency Medical Transport (VAN) | 343900000X | TN | Primary |
Addresses
Primary practice location
1768 Keltner Cir Apt 4
Memphis, TN 38114-4664
Mailing address
1768 Keltner Cir Apt 4
Memphis, TN 38114-4664
Phone (901) 596-9911
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | byyoursiderenaltransportation | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553472000000",
"number": "1154881191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1768 KELTNER CIR APT 4",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381144664",
"telephone_number": "901-596-9911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1768 KELTNER CIR APT 4",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381144664",
"telephone_number": "901-596-9911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROCKETT",
"first_name": "DAMITA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-25",
"last_updated": "2019-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": "TN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "byyoursiderenaltransportation",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "1768 Keltner Cir Apt 4",
"city": "Memphis",
"state": "TN",
"country_code": "US",
"postal_code": "381144664",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.