Individual provider Active NPI

Crissy Collins

  • Urgent Care Clinic/Center
  • Ooltewah, TN
National Provider Identifier
1508258328
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
19747 Issued in TN
Practice address
9219 Lee Hwy Ste 103
Ooltewah, TN 37363-4440
Phone
(423) 648-6483
NPI assigned
Mar 3, 2015
Last updated
Sep 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X 19747 TN Primary
Family Nurse Practitioner 363LF0000X 19747 TN
Registered Nurse 163W00000X 163375 TN

Addresses

Primary practice location

9219 Lee Hwy Ste 103
Ooltewah, TN 37363-4440

Mailing address

9219 Lee Hwy Ste 103
Ooltewah, TN 37363-4440
Phone (423) 648-6483

Other identifiers 1

IdentifierTypeStateIssuer
452345344MedicaidTN

Other names 1

  • Crissy D Baggett Former name

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
I20150529000953 TN Order and Referring Only - Nurse Practitioner 4688994858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
163375TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Bedford Radiology, PLLC Past Accepting new patients
Premier Medical Group PC 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, 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": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1508258328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9219 LEE HWY STE 103",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373634440",
            "telephone_number": "423-648-6483",
            "fax_number": "423-648-6497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9219 LEE HWY STE 103",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373634440",
            "telephone_number": "423-648-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "CRISSY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-03",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "TN",
            "license": "19747",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19747",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "163375",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "452345344",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISSY",
            "last_name": "BAGGETT",
            "middle_name": "D",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ooltewah, TN

Sources for this page

Verify at the official NPI Registry.