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IndividualActiveMedicare EnrolledCan Order/Refer

Charley Crockett

Physician Assistant

NPI: 1376419960Jacksboro, Tennessee, 37757(423) 374-7775Female

About Charley Crockett

Charley Crockett is a female healthcare professional specializing in Physician Assistant, registered under National Provider Identifier (NPI) number 1376419960. Charley Crockett received her medical education at LINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT, graduating in 2025.

Their primary practice is located at 2702 JACKSBORO PIKE, Jacksboro, Tennessee 37757. Patients can reach the office at (423) 374-7775. In addition to the primary location, Charley Crockett maintains 2 additional practice locations.

Charley Crockett is enrolled in Medicare and accepts Medicare patients, is authorized to order and refer Medicare services. Charley Crockett has been NPI-registered since 2025.

Key Metrics

Practice Locations

3

Doctor Details

Identity & Credentials

NPI Number
1376419960
Entity Type
Individual
First Name
Charley
Last Name
Crockett
Gender
Female
Medical School
LINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduation Year
2025
Sole Proprietor
No
Status
active

Primary Practice Location

Address
2702 JACKSBORO PIKE
City
Jacksboro
State
Tennessee
ZIP
37757-4850
Country
United States
Phone
(423) 374-7775

Specialty & Taxonomy

Primary Specialty
Physician Assistant
Classification
Physician Assistant
Taxonomy Code
363A00000X

NPI Registration

Enumeration Date
Last Updated
Certification Date

Mailing Address

Address
4196 HIGHWAY 62 412 STE A
City
HARDY
State
AR
ZIP
725428002

Medicare Enrollment

Medicare Enrolled
Yes
Can Order/Refer
Yes
Telehealth
No
Excluded
No

Frequently Asked Questions

What is Charley Crockett's NPI number?
Charley Crockett's National Provider Identifier (NPI) is 1376419960. An NPI is a unique 10-digit identification number issued by the Centers for Medicare & Medicaid Services (CMS) to healthcare providers in the United States.
What does Charley Crockett specialize in?
Charley Crockett specializes in Physician Assistant. They received their medical education at LINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT (class of 2025).
Where is Charley Crockett located?
Charley Crockett practices at 2702 JACKSBORO PIKE, Jacksboro, Tennessee 37757. You can reach them by phone at (423) 374-7775. They also have 2 additional practice locations.
Does Charley Crockett accept Medicare?
Yes, Charley Crockett is enrolled in the Medicare program and accepts Medicare patients. They are also authorized to order and refer services under Medicare.
Does Charley Crockett offer telehealth or virtual visits?
Charley Crockett does not currently offer telehealth services. In-person visits are required at their practice location.

What is an NPI Number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to healthcare providers in the United States by the Centers for Medicare & Medicaid Services (CMS). Required under HIPAA, every healthcare provider who transmits health information electronically must have an NPI. The NPI for Charley Crockett is 1376419960.