Crockett Spine & Sport Pllc is a medicare enrolled "Chiropractor" provider in Alamo, Tennessee. Their current practice location is
143 S Bells St, Alamo, Tennessee. You can reach out to their office (for appointments etc.) via phone at
(731) 696-2525.
Crockett Spine & Sport Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Crockett Spine & Sport Pllc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1174153738.
Healthcare Provider's Profile
| Full Name | Crockett Spine & Sport Pllc |
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| Type | Facility |
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| Speciality | Chiropractor |
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| Location | 143 S Bells St, Alamo, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1174153738
- Provider Enumeration Date: 01/23/2020
- Last Update Date: 02/28/2020
Medicare PECOS Information:
- PECOS PAC ID: 8325479330
- Enrollment ID: O20200507000556
Medical Identifiers
Medical identifiers for Crockett Spine & Sport Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174153738 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Crockett Spine & Sport Pllc acts as a billing entity for following providers:
| Provider Name | Jake Wayne Whitby |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1922547116
PECOS PAC ID: 8325325301
Enrollment ID: I20170428001076 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Crockett Spine & Sport Pllc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Crockett Spine & Sport Pllc
70 Pecan St,
Alamo, TN 38001-1403
Ph: (731) 696-2525 | Crockett Spine & Sport Pllc
143 S Bells St,
Alamo, TN 38001-1731
Ph: (731) 696-2525 |
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