Crockett Foot and Ankle Clinic, Inc.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

667 Issued in TN

Legal business name

CROCKETT FOOT AND ANKLE CLINIC, INC.

Practice address

369 Brink St
Lawrenceburg, TN 38464-3243

Phone

(931) 766-3040

NPI assigned

May 8, 2007

Last updated

Feb 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James L Chadburn, DPM

Title

Ceo

Phone

(931) 766-3040

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1174736706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 BRINK ST",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "384643243",
            "telephone_number": "931-766-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 BRINK ST",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "384643243",
            "telephone_number": "931-766-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROCKETT FOOT AND ANKLE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "CHADBURN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "931-766-3040",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Crockett Hospital, LLC (Southern Tennessee Regional Health System Lawrenceburg)
• Crockett Kids Pediatrics, P.C.

• Podiatrist in Lawrenceburg, TN
• Providers in Lawrenceburg, TN by specialty
• Podiatrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.