NPIMap

Organization Active NPI

Amg Crockett LLC

Doing business as First Choice Health

  • Family Medicine Physician
  • Lawrenceburg, TN
National Provider Identifier
1851531693
Registry record updated Jun 25, 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
184 Prosser Rd
Lawrenceburg, TN 38464-4233
Phone
(931) 762-1800
Fax
(615) 459-4531
NPI assigned
Mar 5, 2009
Last updated
Jun 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 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) 459-4531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

184 Prosser Rd
Lawrenceburg, TN 38464-4233

Mailing address

184 Prosser Rd
Lawrenceburg, TN 38464-4233
Phone (931) 762-1800

Other names 1

  • First Choice Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071017000313 TN Part B Supplier - Clinic/Group Practice 4789770199 Receives reassigned benefits from 92 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lawrenceburg, TN; Winchester, TN; Pulaski, TN; Mt Pleasant, TN; Loretto, TN; Decherd, TN

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory

Locations

1607 S Locust Ave
Ste 100
Lawrenceburg, TN 38464

1611 S Locust Ave
Ste 200B
Lawrenceburg, TN 38464
Phone (931) 766-3664

1908 N Locust Ave
Lawrenceburg, TN 38464
Phone (931) 244-7600

2121 N Locust Ave
Ste 1
Lawrenceburg, TN 38464
Phone (931) 762-1800

4955 Highway 43 N
#1
Mount Pleasant, TN 38474

1255 E College St
Ste 400
Pulaski, TN 38478
Phone (931) 363-1343

Practitioners & affiliated clinicians

Practitioners 43

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 43

NPI Registry JSON

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1851531693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 PROSSER RD",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "384644233",
            "telephone_number": "931-762-1800",
            "fax_number": "615-459-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 PROSSER RD",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "384644233",
            "telephone_number": "931-762-1800",
            "fax_number": "615-459-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMG CROCKETT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-05",
        "last_updated": "2009-06-25",
        "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": "615-459-4531",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Choice Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.