Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Clay Justin Crockett, PMHNP-BC

Individual provider Nurse Practitioner · NPI 1164120150

Clay Justin Crockett, PMHNP-BC is a Nurse Practitioner in Gilbert, Arizona. Qualified in 2023, 3 years ago. Practices with Dr Gregory Carr MD LLC, an 11-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Arizona, Oregon and Washington.

Years since qualifying
3
Licensed in
AZ, OR, WA
In the registry since
2023
Specialties on file
4
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

1525 S Higley Rd Ste 104
Gilbert, AZ 85296-5045
Phone: (480) 401-2110
Fax: (507) 519-5792
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1166 E Warner Rd Ste 101, Gilbert, AZ 85296-3065 — (480) 401-2110
  • 230 Se 2nd St Ste A, Hermiston, OR 97838-2486 — (541) 289-7777

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 294847 (AZ)
Nurse Practitioner Taxonomy 363L00000X · Licence AP70013458 (WA)
Nurse Practitioner Taxonomy 363L00000X · Licence 10050854 (OR)
Psychiatric/Mental Health Registered Nurse Taxonomy 163WP0808X · Licence RN197246 (AZ)

Record details

NPI number1164120150
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP-BC
Sole proprietorYes
NPI enumeratedFebruary 20, 2023
Last updated in NPPESMarch 23, 2026
Certification dateMarch 23, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Dr Gregory Carr Md Llc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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