Charley Crockett, - Medicare Physician Assistant in Jacksboro, TN

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Charley Crockett, is a medicare enrolled "Physician Assistant" in Jacksboro, Tennessee. She went to Lincoln Memorial University Medical Department and graduated in 2025 and has 1 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Access Medical Clinic Llc and her current practice location is 2702 Jacksboro Pike, Jacksboro, Tennessee. You can reach out to her office (for appointments etc.) via phone at (423) 374-7775.

Charley Crockett is licensed to practice in Tennessee (license number 6819) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1376419960.

Contact Information

Charley Crockett,
2702 Jacksboro Pike,
Jacksboro, TN 37757-4850
(423) 374-7775
(423) 374-7779

Map and Direction




Provider's Profile

Full NameCharley Crockett
GenderFemale
SpecialityPhysician Assistant
Experience1 Years
Location2702 Jacksboro Pike, Jacksboro, Tennessee
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Charley Crockett attended and graduated from Lincoln Memorial University Medical Department in 2025
  NPI Data:
  • NPI Number: 1376419960
  • Provider Enumeration Date: 10/13/2025
  • Last Update Date: 01/14/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 6305331745
  • Enrollment ID: I20251223001166

Medical Identifiers

Medical identifiers for Charley Crockett such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1376419960NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 6819 (Tennessee)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Access Medical Clinic Llc195172180230

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Charley Crockett allows following entities to bill medicare on her behalf.
Entity NameVelocity Medical LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013352269
PECOS PAC ID: 1951541689
Enrollment ID: O20130701000460
Entity NameAccess Medical Clinic LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023621646
PECOS PAC ID: 1951721802
Enrollment ID: O20201015001357

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. Charley Crockett 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 AddressPractice Location Address
Charley Crockett,
4196 Highway 62 412 Ste A,
Hardy, AR 72542-8002

Ph: Not Available		Charley Crockett,
2702 Jacksboro Pike,
Jacksboro, TN 37757-4850

Ph: (423) 374-7775

Reviews and Comments


Physician Assistant Nurses in Jacksboro, TN

Anthony Baird, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 2702 Jacksboro Pike, Jacksboro, TN 37757
Phone: 423-567-4722    
Chelsea M Thacker, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 2702 Jacksboro Pike, Jacksboro, TN 37757
Phone: 423-201-9937    
Hannah Vail Bunch, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 2702 Jacksboro Pike, Jacksboro, TN 37757
Phone: 423-201-9937    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.