Caroline Caitlyn Crocker, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5863 Issued in TN

Practice address

57 Germantown CT Ste 100
Cordova, TN 38018-4274

Phone

(901) 763-0200

NPI assigned

Jan 12, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Novant Health Medical Group Coastal Region LLCGroup PAC ID 2860809936, 577 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141
• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ccrocker1711225@direct.novanthealth.org

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.

• Novant Health Medical Group Coastal Region, LLC

  dba NHMGCR Cape Fear Heart

  • Cardiovascular Disease Physician
  • Wilmington, NC
  • NPI 1649865791
  Medicare reassignment Care Compare group
• Specialty Physician Group LLC

  • Cardiovascular Disease Physician
  • Germantown, TN
  • NPI 1174842181
  Medicare reassignment
• NMG Health Services LLC

  • Maternal & Fetal Medicine Physician
  • Bolivia, NC
  • NPI 1558242495
  NPD
• Novant Health Medical Group Coastal Region, LLC

  dba Novant Health Heart & Vascular Institute

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Wilmington, NC
  • NPI 1083374953
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Methodist Healthcare - Memphis Hospitals

  dba Le Bonheur Children's Hospital

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  dba Le Bonheur Children's Hospital - Germantown

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450
  Care Compare affiliation
• Novant Health New Hanover Regional Medical Center LLC

  dba Novant Health New Hanover Regional Medical Center

  • General Acute Care Hospital
  • Wilmington, NC
  • NPI 1376139139
  Care Compare affiliation

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1174394688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 GERMANTOWN CT STE 100",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184274",
            "telephone_number": "901-763-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "CAROLINE",
        "middle_name": "CAITLYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "5863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacie Whitten Crawford, PA-C
• Jordan Leigh Creamer, DPT
• Armonde Crenshaw Sr., M.A.
• Rhonda Elaine Crenshaw, SP
• Fawn Cress, FNP
• Shelby Crocker, RBT
• Coralotta Cromer
• Bettye Simmons Crouch
• Asia Crowder, BT
• Kathleen Anderson Crowder, LPTA

• Medical Physician Assistant in Cordova, TN
• Providers in Cordova, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.
• 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.

Verify at the official NPI Registry.