Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charley Crockett

Individual provider Physician Assistant · NPI 1376419960

Charley Crockett is a Physician Assistant in Jacksboro, Tennessee. Graduated from Lincoln Memorial University Medical Department in 2025, 1 year ago. Practices with Access Medical Clinic LLC, a 31-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
1
Trained at
Lincoln Memorial University Medical Department
Licensed in
TN
In the registry since
2025

Practice location Address checks out

2702 Jacksboro Pike
Jacksboro, TN 37757-4850
Phone: (423) 374-7775
Fax: (423) 374-7779
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 120 Tanner Pl, Clinton, TN 37716-6684 — (865) 855-3500

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 6819 (TN)

Record details

NPI number1376419960
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 13, 2025
Last updated in NPPESJanuary 14, 2026
Certification dateJanuary 14, 2026
Mailing address4196 Highway 62 412 Ste A, Hardy, AR 72542-8002

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolLINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduated 2025 (1 years in practice)
Group practice Access Medical Clinic Llc — 31 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Jacksboro