NPIMap

Individual provider Active NPI

Frank T. Crockett, M.D.

  • Internal Medicine Physician
  • Dothan, AL
National Provider Identifier
1942277215
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9764 Issued in AL
Practice address
2115 W Main St
Dothan, AL 36301-1289
Phone
(334) 793-6556
Fax
(334) 793-0977
NPI assigned
Mar 4, 2006
Last updated
Feb 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9764 AL Primary

Addresses

Primary practice location

2115 W Main St
Dothan, AL 36301-1289

Mailing address

2115 W Main St
Dothan, AL 36301-1289
Phone (334) 793-6556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100805000759 AL Practitioner - Internal Medicine 8224161625 Reassigns benefits to 1 organization
Practice locations: Dothan, AL

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Alabama School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1108 Ross Clark Cir
Dothan, AL 36301-3022
Phone (334) 793-8087

2115 W Main St
Dothan, AL 36301-1289

2115 W Main St
Dothan, AL 36301-4452
Phone (334) 793-6556

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority Internal Medicine CurrentSince Dec 3, 2017 Accepting new patients
Houston County Healthcare Authority Internal Medicine CurrentSince Dec 3, 2017 Accepting new patients
Houston County Healthcare Authority Internal Medicine Current Accepting new patients
Wiregrass Clinic LLC Internal Medicine PastSince Jun 1, 2013 Accepting new patients
Richard T Kennedy MD LLC Past Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

Networks

  • bcbs alabama network 01H0
  • bcbs alabama network 01C0
  • bcbs alabama network 01E0
  • bcbs alabama network 01A0
  • bcbs alabama network 01B0
  • bcbs alabama network 01G0

Organizations & group practices 5

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1141430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1942277215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011289",
            "telephone_number": "334-793-6556",
            "fax_number": "334-793-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011289",
            "telephone_number": "334-793-6556",
            "fax_number": "334-793-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "FRANK",
        "middle_name": "T.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-04",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "9764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.