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AMG-CROCKETT, LLC
NPI 1912125600
Psychiatry & Neurology - Neurology in Lawrenceburg, TN

Active since April 20, 2007CLIA 44D2114455 · Waiver
1605 S LOCUST AVE, SUITE 103, LAWRENCEBURG, TN 38464(931) 762-6571(931) 766-3339 Get Directions Write a Review

NPPES record last updated: May 18, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Amg-crockett, Llc NPPES

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

AMG-CROCKETT, LLC (NPI 1912125600) is a healthcare organization registered as a neurology in Lawrenceburg, Tennessee and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through June 13, 2028 and lists Jone Koford, Division President, as its authorized official.

NPPES Registry Identity

NPI1912125600
Entity TypeOrganization
Primary Taxonomy2084N0400X
Legal Business NameAMG-CROCKETT, LLC
Location Address1605 S LOCUST AVE, SUITE 103Lawrenceburg, TN 38464-4053
Mailing AddressPo Box ELawrenceburg, TN 38464-0136 · (931) 766-3637 · Fax (931) 766-7071
Phone(931) 762-6571
Fax(931) 766-3339
Organization SubpartNo
Authorized OfficialJone KofordDivision President · (615) 372-8503
Enumeration DateApril 20, 2007
Last NPPES UpdateMay 18, 2009
✔ NPI 1912125600 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Also ListedUrologyTaxonomy 208800000X · License D0042141 (MD)
1605 S LOCUST AVE, Lawrenceburg, TN 38464
Open in Google Maps ↗

Other Identifiers 2

Other01069597TN · Amerigroup
Medicare PIN3370161TN

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 44D2114455

Amg Crockett, LLC Dba Southern Tennessee Neurology-Lawrenceburg · Lawrenceburg, TN
Active · expires Jun 13, 2028
CLIA Number44D2114455
Laboratory TypePhysician Office
Certificate Effective DateJune 14, 2026
Certificate Expiration DateJune 13, 2028
Laboratory DirectorNorman L. Mcnulty
Laboratory Phone(931) 766-3637
Laboratory LocationAmg Crockett, LLC Dba Southern Tennessee Neurology-Lawrenceburg1321 S Locust Ave, Lawrenceburg, TN 38464
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 14

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

DR. NORMAN LIN MCNULTY M.D.
Psychiatry & Neurology (Neurology)
1605 S LOCUST AVE, SUITE 103
LAWRENCEBURG, TN 38464
Lawrence County (931) 766-3637
AMG-CROCKETT, LLC
Psychiatry & Neurology (Neurology)
1605 S LOCUST AVE, SUITE 103
LAWRENCEBURG, TN 38464
Lawrence County (931) 762-6571
AMG-CROCKETT, LLC
Obstetrics & Gynecology (Obstetrics)
1605 S LOCUST AVE, SUITE 200
LAWRENCEBURG, TN 38464
Lawrence County (931) 766-4560
NEUROLOGY ASSOCIATES
Psychiatry & Neurology (Neurology)
1605 S LOCUST AVE
LAWRENCEBURG, TN 38464
Lawrence County (931) 762-4115
SHELDON JON HARIGEL M.D.
Family Medicine
1605 S LOCUST AVE
LAWRENCEBURG, TN 38464
Lawrence County (931) 903-2445
AMG CROCKETT LLC
Orthopaedic Surgery
1605 S LOCUST AVE, SUITE 101
LAWRENCEBURG, TN 38464
Lawrence County (931) 762-4400
LAWRENCEBURG NEUROLOGY ASSOCIATES PC
Specialist
1605 S LOCUST AVE, SUITE 201
LAWRENCEBURG, TN 38464
Lawrence County (931) 766-3035
DR. ELBERT G WARREN III MD
Obstetrics & Gynecology
1605 S LOCUST AVE, STE 200
LAWRENCEBURG, TN 38464
Lawrence County (931) 766-4560

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 1912125600. It was assigned to this organization in the NPPES registry on April 20, 2007.

Where is Amg-Crockett, LLC located?

Amg-Crockett, LLC is located at 1605 S Locust Ave Suite 103, Lawrenceburg, TN 38464. The listed phone number is (931) 762-6571.

What is Amg-Crockett, LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Does Amg-Crockett, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2114455) is associated with this NPI, valid through June 13, 2028. 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 May 18, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.