CROCKETT MEDICAL CLINIC INC
NPI 1104839703
Clinic/Center - Rural Health in Alamo, TN

Active since August 14, 2006CLIA 44D0313215 · Certificate of Compliance
58 S. BELLS ST, ALAMO, TN 38001(731) 696-5401(731) 696-5404 Get Directions Write a Review

NPPES record last updated: August 1, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Crockett Medical Clinic Inc NPPES

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

CROCKETT MEDICAL CLINIC INC (NPI 1104839703) is a healthcare organization registered as a rural health in Alamo, Tennessee and active in the NPI registry since August 2006. The organization holds a CLIA Certificate of Compliance certificate valid through July 31, 2026 and lists Rita Croom, Cfo, as its authorized official.

NPPES Registry Identity

NPI1104839703
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameCROCKETT MEDICAL CLINIC INC
Location Address58 S. BELLS STAlamo, TN 38001
Mailing Address58 S. Bells StAlamo, TN 38001 · (731) 696-5401 · Fax (731) 696-5404
Fax(731) 696-5404
Organization SubpartNo
Authorized OfficialRita CroomCfo · (731) 696-4670
Enumeration DateAugust 14, 2006
Last NPPES UpdateAugust 1, 2025
NPPES CertifiedJuly 7, 2025
NPI 1104839703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
Also ListedNurse PractitionerTaxonomy 363L00000X
58 S. BELLS ST, Alamo, TN 38001

Other Identifiers 2

Other3717707TN · Ptan
Medicaid3717707TN

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

Accepted Insurance

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 Compliance 44D0313215

Crockett Medical Clinic, Inc · Alamo, TN
Active · expires Jul 31, 2026
CLIA Number44D0313215
Laboratory TypePhysician Office
Certificate Effective DateAugust 1, 2024
Certificate Expiration DateJuly 31, 2026
Laboratory DirectorDr. Loren S. Carroll
Laboratory Phone(731) 696-5401
Laboratory LocationCrockett Medical Clinic, Inc58 South Bells St, Alamo, TN 38001
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
58 S. BELLS ST
ALAMO, TN 38001
Nurse Practitioner
58 S. BELLS ST
ALAMO, TN 38001

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 Crockett Medical Clinic Inc's NPI number?

The NPI number for Crockett Medical Clinic Inc is 1104839703. It was assigned to this organization in the NPPES registry on August 14, 2006.

Where is Crockett Medical Clinic Inc located?

Crockett Medical Clinic Inc is located at 58 S. Bells St, Alamo, TN 38001. The listed phone number is (731) 696-5401.

What is Crockett Medical Clinic Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Crockett Medical Clinic Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 44D0313215) is associated with this NPI, valid through July 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Crockett Medical Clinic Inc accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list Crockett Medical Clinic Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Crockett Medical Clinic Inc was last updated on August 1, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.