Charley Crockett
NPI 1376419960 · Physician Assistant · Jacksboro, TN
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Charley Crockett is a Physician Assistant provider in Jacksboro, TN (NPI 1376419960).
Provider details
- NPI number
- 1376419960
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 6819 (TN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 120 Tanner PlClinton, TN 37716-6684Phone: (865) 855-3500Fax: (865) 855-4500
Registry dates
- Enumerated
- 2025-10-13
- Last updated
- 2026-01-14
- Certified
- 2026-01-14
Frequently asked questions
- What is Charley Crockett's NPI number?
- Charley Crockett's National Provider Identifier (NPI) is 1376419960, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Charley Crockett's specialty?
- Charley Crockett is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Charley Crockett located?
- Charley Crockett's practice location on file with NPPES is 2702 Jacksboro Pike, Jacksboro, TN 37757-4850.
- What is Charley Crockett's phone number?
- The practice phone number listed in the NPPES registry for Charley Crockett is (423) 374-7775.
- Does Charley Crockett accept Medicare?
- Charley Crockett is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Charley Crockett's NPI active?
- Yes — Charley Crockett's NPI (1376419960) is active in the NPPES registry as of the last update on 2026-01-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.