Jeffrey H Hernandez (NPI# 1730565789, PAC ID# 4688984552) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1730565789 |
| PAC ID by PECOS | 4688984552 |
| Professional Enrollment ID | I20151104002087 |
| Full Name | Jeffrey H Hernandez |
| Organization Legal Name | AMG-CROCKETT, LLC |
| Address |
106 S Military St B Loretto TN 38469-2100 |
| Phone Number | 9318534622 |
| Gender | M |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4789770199 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440175 | SOUTHERN TENNESSEE REGIONAL HEALTH SYSTEM LAWRENCE |
| Address | Phone | Organization |
|---|---|---|
| 106 S Military St, B, Loretto, TN 38469-2100 | 9318534622 | AMG-CROCKETT, LLC |
| 106 S Military St, Loretto, TN 38469-2100 | 9318534622 | AMG-CROCKETT, LLC |
| Organization Legal Name | AMG-CROCKETT, LLC |
| Physicians | 27 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Racheal M Kightlinger | Nurse Practitioner | Amg-crockett, LLC | 2019 N Locust Ave, Lawrenceburg, TN 38464-2337 |
| John P. Kristofich | Cardiovascular Disease (cardiology) | Amg-crockett, LLC | 1611 S Locust Ave, Suite 200b, Lawrenceburg, TN 38464-4055 |
| Alvin Matthew Maliakal | Internal Medicine | Amg-crockett, LLC | 184 Prosser Rd, Lawrenceburg, TN 38464-4233 |
| Katrina M. Dial | Certified Nurse Midwife (cnm) | Amg-crockett, LLC | 1605 S Locust Ave, Suite 101, Lawrenceburg, TN 38464-4053 |
| Tracey K Williams | Nurse Practitioner | Amg-crockett, LLC | 4955d Hwy 43 N, Mount Pleasant, TN 38474-5010 |
| Norman Mcnulty | Neurology | Amg-crockett, LLC | 1321 S Locust Ave, Lawrenceburg, TN 38464-4040 |
| Elbert G Warren | Obstetrics/gynecology | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| Haley Beecham Phillips | Nurse Practitioner | Amg-crockett, LLC | 2019 N Locust Ave, Lawrenceburg, TN 38464-2337 |
| Amanda D Haneline | Obstetrics/gynecology | Amg-crockett, LLC | 1605 S Locust Ave, Lawrenceburg, TN 38464-4053 |
| Brooke Huffsmith | Obstetrics/gynecology | Amg-crockett, LLC | 1605 S Locust Ave, Lawrenceburg, TN 38464-4053 |
| Street Address |
106 S MILITARY ST B |
| City | LORETTO |
| State | TN |
| Zip | 38469-2100 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elbert G Warren | Obstetrics/gynecology | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| Marie Mattei-weiland | Nurse Practitioner | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| Kelly C Baldwin | Urology | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| Whitney Brooke Franklin | Nurse Practitioner | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| William L Fontenot | Orthopedic Surgery | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| Nikki Lee Davenport | Nurse Practitioner | Amg-crockett, LLC | 106 S Military St, B, Loretto, TN 38469-2100 |
| Clayton D. Wilson | Family Practice | Amg-crockett, LLC | 106 S Military St, Loretto, TN 38469-2100 |
| Monica L Newton | Nurse Practitioner | Amg-crockett, LLC | 106 S Military St, Loretto, TN 38469-2100 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew E Schantz | Family Medicine | 206 S Military St, Suite 1, Loretto, TN 38469-2101 | |
| Emily V Gillespie | Nurse Practitioner | Ecm Health Group LLC | 722 N Military St, Loretto, TN 38469-2336 |
| Steven N Mashburn | Nurse Practitioner | Ecm Health Group LLC | 722 N Military St, Loretto, TN 38469-2336 |
| Johnathon L Jacobs Ii | Chiropractic | Loretto Family Chiropractic | 607 A N Military St, Loretto, TN 38469-2341 |
| Chasy Jacobs | Chiropractic | Loretto Family Chiropractic | 607 A N Military St, Loretto, TN 38469-2341 |
| City | LORETTO |
| Zip Code | 38469 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LORETTO + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.