Caleb Crocker

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

4901 Issued in TN

Practice address

3443 Dickerson Pike Ste 190
Nashville, TN 37207-2533

Phone

(615) 860-1580

NPI assigned

Jul 25, 2017

Sex

Male

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 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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hughston Clinic Southeast PCGroup PAC ID 9234423971, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tristar Skyline Medical Center Hospital, Nashville, TN, CCN 440006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: caleb.crocker.1@321.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hughston Clinic Southeast PC

  • Orthopaedic Surgery Physician
  • Columbus, GA
  • NPI 1225401946

  TN

  Medicare reassignment Care Compare group NPD
• Hughston Clinic Southeast PC

  • Durable Medical Equipment & Medical Supplies
  • Nashville, TN
  • NPI 1770004863
  NPD

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

• Hti Memorial Hospital Corporation

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1295780476
  Care Compare affiliation

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1902329550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370",
            "fax_number": "706-494-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 DICKERSON PIKE STE 190",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372072533",
            "telephone_number": "615-860-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "CALEB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-25",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "4901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q076869",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Cristan, LPC-MHSP
• Hannika Angelique Cristante
• Sarah Louise East Criste, MS
• David Crnobori
• Alexandra Crochet, LPC-MHSP (TEMP)
• Kristina Crocker, FNP-BC
• Krystal Crocker, BCBA
• Christy Johnson Crockett, M.D.
• Kristoffer Gioavanti Crockett
• Larry M. Crockett, ARNP

• Surgical Physician Assistant in Nashville, TN
• Providers in Nashville, TN by specialty
• Surgical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.