Individual provider Active NPI

Beth Crouch, DNP, APRN, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1245890631
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
24266 Issued in TN
Practice address
110 W Springbrook Dr Ste a
Johnson City, TN 37604-1701
Phone
(423) 929-2044
NPI assigned
Jun 18, 2019
Last updated
Jun 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 24266 TN Primary

Addresses

Primary practice location

110 W Springbrook Dr Ste a
Johnson City, TN 37604-1701

Mailing address

232 Redstone Dr
Bluff City, TN 37618-1522
Phone (423) 366-3635

Other practice location 1

202 W Fairview Ave
Johnson City, TN 37604-5611
Phone (423) 439-7371

Other practice location 2

2151 Century Ln
Johnson City, TN 37604-4469
Phone (423) 926-2555

Other practice location 3

807 University Pkwy
Nicks Hall, Room 160
Johnson City, TN 37614
Phone (423) 439-4225

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240619000080 TN Practitioner - Nurse Practitioner 0143763144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Tennessee State UniversityGroup PAC ID 2769394774, 21 clinicians

Practice addresses (Care Compare)

202 W Fairview Ave
Johnson City, TN 37604-5611
Phone (423) 439-7371

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee State University CurrentSince Jun 3, 2024 Accepting new patients
East Tennessee State University CurrentSince Jun 3, 2024 Accepting new patients
Caris Healthcare Past Accepting new patients
East Tennessee State University Past Accepting new patients
Caris Healthcare Past Accepting new patients

Locations

202 W Fairview Ave
Johnson City, TN 37604
Phone (423) 439-7371

2151 Century Ln
Johnson City, TN 37604
Phone (423) 439-4071

2700 Main St
Sneedville, TN 37869
Phone (423) 733-2819

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1245890631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 REDSTONE DR",
            "city": "BLUFF CITY",
            "state": "TN",
            "postal_code": "376181522",
            "telephone_number": "423-366-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W SPRINGBROOK DR STE A",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041701",
            "telephone_number": "423-929-2044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 W Fairview Ave",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376045611",
            "country_code": "US",
            "telephone_number": "423-439-7371",
            "fax_number": "423-232-0420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2151 Century Ln",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376044469",
            "country_code": "US",
            "telephone_number": "423-926-2555",
            "fax_number": "423-926-5999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "807 University Pkwy",
            "address_2": "Nicks Hall, Room 160",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "37614",
            "country_code": "US",
            "telephone_number": "423-439-4225",
            "fax_number": "423-439-4560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "BETH",
        "credential": "DNP, APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "24266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.