Larry G Crisp (NPI# 1275693921, PAC ID# 9537116652) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1275693921 |
| PAC ID by PECOS | 9537116652 |
| Professional Enrollment ID | I20050331001051 |
| Full Name | Larry G Crisp |
| Organization Legal Name | INTERNAL MEDICINE ASSOCIATES OF MCMINN COUNTY PC |
| Address |
301 Grady Rd Etowah TN 37331-1924 |
| Phone Number | 4232632444 |
| Gender | M |
| Credential | NP |
| Graduation Year | 2004 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7113001074 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440068 | STARR REGIONAL MEDICAL CENTER ATHENS |
| Address | Phone | Organization |
|---|---|---|
| 301 Grady Rd, Etowah, TN 37331-1924 | 4232632444 | INTERNAL MEDICINE ASSOCIATES OF MCMINN COUNTY PC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | INTERNAL MEDICINE ASSOCIATES OF MCMINN COUNTY PC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Russell B Watters Iii | Internal Medicine | Internal Medicine Associates of Mcminn County PC | 301 Grady Rd, Etowah, TN 37331-1924 |
| Nathan C Trentham | Internal Medicine | Internal Medicine Associates of Mcminn County PC | 301 Grady Rd, Etowah, TN 37331-1924 |
| Martha Jean C Pascarella | Nurse Practitioner | Internal Medicine Associates of Mcminn County PC | 301 Grady Rd, Etowah, TN 37331-1924 |
| Joel C Riley Ii | Internal Medicine | Internal Medicine Associates of Mcminn County PC | 301 Grady Rd, Etowah, TN 37331-1924 |
| Samuel J Olsen Ii | Internal Medicine | Internal Medicine Associates of Mcminn County PC | 301 Grady Rd, Etowah, TN 37331-1924 |
| Street Address |
301 GRADY RD |
| City | ETOWAH |
| State | TN |
| Zip | 37331-1924 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Russell B Watters Iii | Internal Medicine | Internal Medicine Associates of Mcminn County PC | 301 Grady Rd, Etowah, TN 37331-1924 |
| Nathan C Trentham | Internal Medicine | Internal Medicine Associates of Mcminn County PC | 301 Grady Rd, Etowah, TN 37331-1924 |
| Martha Jean C Pascarella | Nurse Practitioner | Internal Medicine Associates of Mcminn County PC | 301 Grady Rd, Etowah, TN 37331-1924 |
| Joel C Riley Ii | Internal Medicine | Internal Medicine Associates of Mcminn County PC | 301 Grady Rd, Etowah, TN 37331-1924 |
| Samuel J Olsen Ii | Internal Medicine | Internal Medicine Associates of Mcminn County PC | 301 Grady Rd, Etowah, TN 37331-1924 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James B Durkin | Family Medicine | 250 Grady Rd, Etowah, TN 37331-1902 | |
| Joshua Blair | Nurse Practitioner | 315 Grady Rd, Etowah, TN 37331-1903 | |
| Donald H Watters | Family Medicine | 305 Grady Rd A, Etowah, TN 37331-1903 |
| City | ETOWAH |
| Zip Code | 37331 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | ETOWAH + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Larry G Crisp.
| 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.