Active NPI
Bettye Simmons Crouch
- Pharmacist
- Cordova, TN
National Provider Identifier
1255612271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- TN5052
- Practice address
- 9028 Walnut Grove Rd
Cordova, TN 38018-7469 - Phone
- (901) 754-3945
- Fax
- (901) 754-5472
- NPI assigned
- Sep 3, 2011
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | TN5052 | TN | Primary |
Addresses
Primary practice location
9028 Walnut Grove Rd
Cordova, TN 38018-7469
Mailing address
9028 Walnut Grove Rd
Cordova, TN 38018-7469
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TN5052 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315008000000",
"number": "1255612271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9028 WALNUT GROVE RD",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380187469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9028 WALNUT GROVE RD",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380187469",
"telephone_number": "901-754-3945",
"fax_number": "901-754-5472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROUCH",
"first_name": "BETTYE",
"middle_name": "SIMMONS",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-03",
"last_updated": "2011-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "TN5052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.