| Crockett Medical Clinic Inc | |
|
58 S. Bells St Alamo TN 38001 | |
| (731) 696-5401 | |
| (731) 696-5404 |
| Full Name | Crockett Medical Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 58 S. Bells St, Alamo, Tennessee |
| Authorized Official Name and Position | Rita Croom (CFO) |
| Authorized Official Contact | 7316964670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crockett Medical Clinic Inc 58 S. Bells St Alamo TN 38001 Ph: (731) 696-5401 | Crockett Medical Clinic Inc 58 S. Bells St Alamo TN 38001 Ph: (731) 696-5401 |
| NPI Number | 1104839703 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 08/01/2025 |
| Medicare PECOS PAC ID | 8921009812 |
|---|---|
| Medicare Enrollment ID | O20070119000217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104839703 | NPI | - | NPPES |
| 3717707 | Other | TN | PTAN |
| 3717707 | Medicaid | TN |
| Provider Name | Raymond W Rhear |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659384253 PECOS PAC ID: 9436146370 Enrollment ID: I20040430000554 |
| Provider Name | Karen E Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902819501 PECOS PAC ID: 7517955446 Enrollment ID: I20040430001308 |
| Provider Name | Lori F Laman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295906378 PECOS PAC ID: 5597844001 Enrollment ID: I20080509000046 |
| Provider Name | Donna P Clement |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629272620 PECOS PAC ID: 8628145596 Enrollment ID: I20080917000833 |
| Provider Name | Rebecca Ann Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730418385 PECOS PAC ID: 7517009509 Enrollment ID: I20100322000385 |
| Provider Name | Kristin Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548569700 PECOS PAC ID: 2163609009 Enrollment ID: I20110602000260 |
| Provider Name | Loren S Carroll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104168178 PECOS PAC ID: 0749409209 Enrollment ID: I20150421001883 |
Alamo Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 157 N Bells St, Alamo, TN 38001 Phone: 731-696-5551 Fax: 731-696-2802 |