NPIMap

Individual provider Active NPI

Bridget R Crockett, ANP

  • Family Nurse Practitioner
  • Searcy, AR
National Provider Identifier
1952566440
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A03144 Issued in AR
Practice address
112 Brantly Road
Searcy, AR 72143-6113
Phone
(501) 268-6102
Fax
(501) 268-4445
NPI assigned
Jul 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ATP-000160 AR
Family Nurse Practitioner 363LF0000X A03144 AR Primary

Addresses

Primary practice location

112 Brantly Road
Searcy, AR 72143-6113

Mailing address

112 Brantley Rd
Searcy, AR 72143-8315
Phone (501) 268-6102

Other identifiers 1

IdentifierTypeStateIssuer
176018758MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20090205000070 AR Practitioner - Nurse Practitioner 3072677079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

505 S Elm St
Suite C
Searcy, AR 72143-6604
Phone (501) 388-6689

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ATP-000160ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arcare Past Accepting new patients
State of Arkansas Past Accepting new patients
State of Arkansas Past Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1952566440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 BRANTLEY RD",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721438315",
            "telephone_number": "501-268-6102",
            "fax_number": "501-268-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 BRANTLY ROAD",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721436113",
            "telephone_number": "501-268-6102",
            "fax_number": "501-268-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "BRIDGET",
        "middle_name": "R",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "ATP-000160",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A03144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176018758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Searcy, AR

Sources for this page

Verify at the official NPI Registry.