CROCKETT MEDICAL CENTER CLINIC
NPI 1487155990
Family Medicine in Crockett, TX
About Crockett Medical Center Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CROCKETT MEDICAL CENTER CLINIC (NPI 1487155990) is a healthcare organization registered as a family medicine in Crockett, Texas and active in the NPI registry since February 2018. The organization lists Kelly Eugene Tjelmeland, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 6
Other Names 1
Other Identifiers 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Crockett Medical Center Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
7Medicare enrollment records show 7 clinicians reassign Medicare billing to Crockett Medical Center Clinic, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (7)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Center, LLC's NPI number?
The NPI number for Crockett Medical Center, LLC is 1487155990. It was assigned to this organization in the NPPES registry on February 21, 2018. The provider is doing business as Crockett Medical Center Clinic.
Where is Crockett Medical Center, LLC located?
Crockett Medical Center, LLC is located at 1050 E Loop 304, Crockett, TX 75835. The listed phone number is (936) 546-3890.
What is Crockett Medical Center, LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Crockett Medical Center, LLC enrolled in Medicare?
Yes. Crockett Medical Center, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Crockett Medical Center, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 5 Medicare specialties reassign their Medicare billing to Crockett Medical Center, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (3), Cardiovascular Disease (Cardiology) (1) and Nurse Practitioner (1). Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Crockett Medical Center, LLC accept?
Health plans from Blue Cross and Blue Shield of Texas list Crockett Medical Center, LLC 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 Center, LLC was last updated on August 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Crockett Medical Center Clinic · NPI 1487155990
Family Medicine organization in Crockett, Texas. Organization record, active in the CMS NPPES registry since February 21, 2018.
## Identity
- **NPI:** 1487155990 (Entity type: Organization)
- **Enumerated:** February 21, 2018
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Crockett Medical Center, Llc
- **Organization subpart:** No
- **Authorized official:** Kelly Tjelmeland, CEO
## Practice location
- **Address:** 1050 E LOOP 304, Crockett, TX 75835
- **Phone:** (936) 546-3890
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 7 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (3), Cardiovascular Disease (Cardiology) (1), Nurse Practitioner (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 28, 2018
- **Other identifiers:** Medicaid 385139602 (TX); Medicaid 385139603 (TX); Medicaid 385139601 (TX)
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Source: [NPI Profile](https://npiprofile.com/npi/1487155990) · Data from the CMS NPPES public registry.