NPIMap

Organization Active NPI

Amg Crockett LLC

Doing business as Summertown Medical Center

  • Family Medicine Physician
  • Mt Pleasant, TN
National Provider Identifier
1316349764
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AMG CROCKETT LLC
Doing business as
Summertown Medical Center
Practice address
4955 Highway 43 N
Mount Pleasant, TN 38474-5010
Phone
(615) 920-7231
NPI assigned
Sep 17, 2014
Last updated
Sep 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Authorized official

Name
Leanne Barrett
Title
Director
Phone
(615) 920-7231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

4955 Highway 43 N
Mount Pleasant, TN 38474-5010

Mailing address

4955 Highway 43 N
Mount Pleasant, TN 38474-5010

Other names 1

  • SUMMERTOWN MEDICAL CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071017000313 TN Part B Supplier - Clinic/Group Practice 4789770199 Receives reassigned benefits from 92 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lawrenceburg, TN; Winchester, TN; Pulaski, TN; Mt Pleasant, TN; Loretto, TN; Decherd, TN

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory

Locations

4955 Highway 43 N
Mount Pleasant, TN 38474
Phone (615) 920-7231

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410912000000",
    "number": "1316349764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 HIGHWAY 43 N",
            "city": "MOUNT PLEASANT",
            "state": "TN",
            "postal_code": "384745010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 HIGHWAY 43 N",
            "city": "MOUNT PLEASANT",
            "state": "TN",
            "postal_code": "384745010",
            "telephone_number": "615-920-7231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMG CROCKETT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2014-09-17",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "LEANNE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-920-7231"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUMMERTOWN MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mt Pleasant, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.