NPIMap

Organization Active NPI

Amg Crockett LLC

Doing business as First Choice Health

  • Family Medicine Physician
  • Loretto, TN
National Provider Identifier
1659514776
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AMG CROCKETT LLC
Doing business as
First Choice Health
Practice address
106 S Military Ave
Loretto, TN 38469-2101
Phone
(931) 853-4622
Fax
(931) 853-4621
NPI assigned
Apr 20, 2009
Last updated
Apr 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Authorized official

Name
Mr. Michael B Clark
Title
President
Phone
(615) 372-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

106 S Military Ave
Loretto, TN 38469-2101

Mailing address

106 S Military Ave
Loretto, TN 38469-2101
Phone (931) 853-4622

Other names 1

  • First Choice Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Amg-Crockett LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

106 S Military St
Loretto, TN 38469
Phone (931) 853-4622

Practitioners & affiliated clinicians

Practitioners 90

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 90

NPI Registry JSON

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240185600000",
    "number": "1659514776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S MILITARY AVE",
            "city": "LORETTO",
            "state": "TN",
            "postal_code": "384692101",
            "telephone_number": "931-853-4622",
            "fax_number": "931-853-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S MILITARY AVE",
            "city": "LORETTO",
            "state": "TN",
            "postal_code": "384692101",
            "telephone_number": "931-853-4622",
            "fax_number": "931-853-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMG CROCKETT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-20",
        "last_updated": "2009-04-20",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-372-8500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Choice Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loretto, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.