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SOUTHERN TENNESSEE HEART
NPI 1013374073
Internal Medicine - Cardiovascular Disease in Lawrenceburg, TN

Active since January 21, 2016CLIA 44D2291964 · Waiver
1611 S LOCUST AVE, SUITE 200B, LAWRENCEBURG, TN 38464(931) 766-3684 Get Directions Write a Review

NPPES record last updated: January 21, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southern Tennessee Heart NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN TENNESSEE HEART (NPI 1013374073) is a healthcare organization registered as a cardiovascular disease in Lawrenceburg, Tennessee and active in the NPI registry since January 2016. The organization holds a CLIA Waiver certificate valid through October 17, 2027 and lists Casey J. Willis, Market Manager, as its authorized official.

NPPES Registry Identity

NPI1013374073
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameAMG CROCKETT LLC
Location Address1611 S LOCUST AVE, SUITE 200BLawrenceburg, TN 38464-4055
Mailing Address1611 S Locust Ave, Suite 200bLawrenceburg, TN 38464-4055 · (931) 766-3684
Phone(931) 766-3684
Organization SubpartNo
Authorized OfficialCasey J. WillisMarket Manager · (931) 766-4574
Enumeration DateJanuary 21, 2016
✔ NPI 1013374073 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
1611 S LOCUST AVE, Lawrenceburg, TN 38464
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Other Names 1

Doing Business AsSouthern Tennessee Heart

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2291964

Southern Tennessee Heart · Lawrenceburg, TN
Active · expires Oct 17, 2027
CLIA Number44D2291964
Laboratory TypePhysician Office
Certificate Effective DateOctober 18, 2025
Certificate Expiration DateOctober 17, 2027
Laboratory DirectorBrian Cole
Laboratory Phone(931) 766-0077
Laboratory LocationSouthern Tennessee Heart1323 S Locust Ave, Lawrenceburg, TN 38464
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amg Crockett LLC's NPI number?

The NPI number for Amg Crockett LLC is 1013374073. It was assigned to this organization in the NPPES registry on January 21, 2016. The provider is doing business as Southern Tennessee Heart.

Where is Amg Crockett LLC located?

Amg Crockett LLC is located at 1611 S Locust Ave Suite 200B, Lawrenceburg, TN 38464. The listed phone number is (931) 766-3684.

What is Amg Crockett LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Does Amg Crockett LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2291964) is associated with this NPI, valid through October 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Amg Crockett LLC was last updated on January 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.