MRS. TANYA EZELL CROCKETT APRN, CPNP-PC
NPI 1740564954
Nurse Practitioner - Pediatrics in Louisville, KY

Q: What is Tanya Crockett's NPI number?

The NPI number for Tanya Crockett is 1740564954. It was assigned to this individual provider in the NPPES registry on October 6, 2011.

Q: What is Tanya Crockett's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Tanya Crockett was last updated on February 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.

Active since October 06, 2011PECOS EnrolledAccepts Medicare Assignment

231 E CHESTNUT ST, LOUISVILLE, KY 40202(502) 629-4750(502) 629-4617 Get Directions Write a Review

NPPES record last updated: February 24, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 22, 2019, Nov 15, 2016 (2 updates tracked since 2016).

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About Mrs. Tanya Ezell Crockett Aprn, Cpnp-pc NPPES

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

MRS. TANYA EZELL CROCKETT APRN, CPNP-PC (NPI 1740564954) is an individual pediatrics provider in Louisville, Kentucky, licensed in Kentucky (3007181) and active in the NPI registry since October 2011. She is enrolled in Medicare PECOS, maintains a secondary practice location in Lexington, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1740564954

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameMRS. TANYA EZELL CROCKETTCredential: APRN, CPNP-PC

Location Address231 E CHESTNUT STLouisville, KY 40202-1821

Mailing AddressPo Box 776879Chicago, IL 60677-6879 · (502) 588-9490 · Fax (502) 272-5116

Phone(502) 629-4750

Fax(502) 629-4617

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateOctober 6, 2011

Last NPPES UpdateFebruary 24, 20262 updates tracked since enumeration

NPPES CertifiedFebruary 24, 2026

✔ NPI 1740564954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in KY · 3007181

231 E CHESTNUT ST, Louisville, KY 40202

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Secondary Practice Location 1

Location 1496 Southland DrLexington, KY 40503-1827 · Phone (859) 288-2425 · Fax (859) 721-3918

Other Identifiers 1

Medicaid7100197040KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Tanya Ezell Crockett Aprn, Cpnp-pc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759660707

PECOS Enrollment IDI20260325000861

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40202 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

HERON BAUMGARTEN

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