Teresa Crockett, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R538248 Issued in MS

Practice address

12 East Brunswick
Byhalia, MS 38611

Phone

(662) 838-2163

Fax

(662) 838-7944

NPI assigned

Jun 10, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Mississippi Health Care IncGroup PAC ID 5294717377, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HECABD
• Direct secure messaging: teresa.crockett@lcabe.eclinicaldirectplus.com

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.

• Northeast Mississippi Health Care, Inc.

  dba Byhalia Family Health Center - Medical

  • Federally Qualified Health Center (FQHC)
  • Byhalia, MS
  • NPI 1558410738
  Medicare reassignment Care Compare group NPD
• Northeast Mississippi Health Care, Inc.

  dba Mt. Pleasant Family Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Mt. Pleasant, MS
  • NPI 1386792992
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Memorial Hospital-Desoto, Inc,

  • General Acute Care Hospital
  • Southaven, MS
  • NPI 1194789818
  Care Compare affiliation

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770587388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 698",
            "city": "BYHALIA",
            "state": "MS",
            "postal_code": "386110698",
            "telephone_number": "662-838-2163",
            "fax_number": "662-838-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 EAST BRUNSWICK",
            "city": "BYHALIA",
            "state": "MS",
            "postal_code": "38611",
            "telephone_number": "662-838-2163",
            "fax_number": "662-838-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R538248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015390",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Byhalia Drug
• Byhalia Drug Company LLC
• Byhalia Vision Center LLC
• Lacutlass Sharnise Byno, NP
• Annabelle D. Cabe, M.D.
• Kimberly Lashun Cross, NP
• Brenda Davis, FNP
• Brittney L Duncan, PMHNP
• Louella M. Edwards-Frye, APRN, FNP-C
• Marrieta Felicitas

• Nurse Practitioner in Byhalia, MS
• Providers in Byhalia, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.