Individual provider Active NPI

Craig Middleton Rockett III, D.D.S.

  • General Practice Dentistry
  • Bristol, TN
National Provider Identifier
1972670941
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
TNDS4644 Issued in TN
Practice address
200 Bluff City Hwy
Bristol, TN 37620-4215
Phone
(423) 764-2166
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X TNDS4644 TN Primary

Addresses

Primary practice location

200 Bluff City Hwy
Bristol, TN 37620-4215

Mailing address

200 Bluff City Hwy
Bristol, TN 37620-4215
Phone (423) 764-2166

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160209001936 TN Order and Referring Only - DentistPractitioner - Dentist 0244534469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972670941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BLUFF CITY HWY",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376204215",
            "telephone_number": "423-764-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BLUFF CITY HWY",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376204215",
            "telephone_number": "423-764-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKETT",
        "first_name": "CRAIG",
        "middle_name": "MIDDLETON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "TNDS4644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.