Individual provider Active NPI

Veronica Crowell

  • Family Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1487059143
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19307 Issued in TN
Practice address
7691 Poplar Ave
Germantown, TN 38138-3904
Phone
(901) 516-8277
Fax
(901) 385-5225
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 19307 TN
Family Nurse Practitioner 363LF0000X 19307 TN Primary

Addresses

Primary practice location

7691 Poplar Ave
Germantown, TN 38138-3904

Mailing address

PO Box 1390
Southaven, MS 38671-0015

Other names 1

  • Veronica Ann Riccardi Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AL2 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

Enrollment IDStateProvider typePAC IDDetails
I20150402000775 TN Practitioner - Nurse Practitioner 2466779301 Reassigns benefits to 2 organizations
I20230126000133 AL Practitioner - Nurse Practitioner 2466779301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ies Alabama PLLCGroup PAC ID 5395105183, 23 clinicians

Practice addresses (Care Compare)

1613 N McKenzie St
Foley, AL 36535-2247
Phone (251) 949-3540

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19307TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
T M Carr MD PC CurrentSince Jan 1, 2015 Accepting new patients
Ies Alabama PLLC CurrentSince Jun 28, 2023 Accepting new patients

Locations

1613 N McKenzie St
Foley, AL 36535
Phone (251) 949-3400

3590 Gulf Shores Pkwy
Gulf Shores, AL 36542
Phone (251) 215-4853

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

Organizations & group practices 3

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": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1487059143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1390",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386710015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7691 POPLAR AVE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383904",
            "telephone_number": "901-516-8277",
            "fax_number": "901-385-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWELL",
        "first_name": "VERONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "19307",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VERONICA",
            "last_name": "RICCARDI",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.