Laurie Danielle Crockett, APRN
Individual provider Active NPI Family Nurse Practitioner · Artesia, NM
NPI 1700417136 · NPPES record last updated Sep 24, 2021
Key facts
- NPI
- 1700417136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 59186 (NM)
- Practice address
- 702 N 13TH St
Artesia, NM 88210-1166 - Phone
- (575) 746-3119
- Fax
- (575) 746-4295
- NPI assigned
- Feb 4, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Artesia General Hospital
Practice addresses (Care Compare)
105 E Hagerman
Artesia Healthcare Professionals
Carlsbad, NM 88220-0000
Phone (575) 885-2180
Hospital & facility affiliations
- Artesia General Hospital
- University Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200330003654 | NM | Practitioner - Nurse Practitioner | 3678902491 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Artesia General Hospital | Current |
Accepting new patients | |
| Artesia General Hospital | Current |
Accepting new patients | |
| Artesia General Hospital | Family | Current | Accepting new patients |
| Southwestern Regional Medical Center | Family | Past | Accepting new patients |
Locations
612 N 13th St
Ste G
Artesia, NM 88210
Phone (505) 736-8262
702 N 13th St
Artesia, NM 88210
Phone (505) 748-3333
612 N 13th St
Ste D
Artesia, NM 88210
Phone (575) 736-8270
2411 Osborne Rd
Carlsbad, NM 88220
Phone (505) 885-2188
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/artesia-6a02e1ef
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 59186 | NM | Yes |
Addresses
Primary practice location
702 N 13TH St
Artesia, NM 88210-1166
Mailing address
702 N 13TH St
Artesia, NM 88210-1199
Phone (575) 746-3119
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 99702096 | Medicaid | NM |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | laurie.pittman@21739.direct.athenahealth.com | ||
| Direct Messaging Address | mfp@artesiageneral.hin.us | Direct |
Other providers in Artesia, NM
- Archella Simone Clay
- Breanna Contreras
- Covenant Child Inc
- Ruth Honey Covin-Weeks
- Xan Creighton
- Patricia A Crook
- Rachel Crutcher
- Rosanna M D'Amico
- Susan Dade
- Samantha Davis
All providers in Artesia, NM · Family Nurse Practitioner in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.