DONNA CROCKETT (APRN) – Family Nurse Practitioner, NPI 1174411219

DONNA CROCKETT (APRN) is a healthcare provider. based in London, Kentucky. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 4042815 (KY). The NPI Number for DONNA CROCKETT (APRN) is 1174411219

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
DONNA CROCKETT (APRN)
NPI
1174411219
Phone
(606) 330-7835
Address
PO BOX 936
Enumeration Date
26 June 2025
Last Update Date
18 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8599675044
Graduation Year
2025 (1 year ago)
PAC ID
9537677646
Group Practice PAC ID
4183641400
Professional Enrollment ID
I20250731003057
Address ID
KY405092124LE160XXDRXX502
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness85
Years active:0State licenses:1Digital endpointsOther names

7,343 NURSE PRACTITIONER in KY

Provider Addresses for DONNA CROCKETT (APRN)

  • PO BOX 936

    LONDON, KY 407430936

    Phone: (606) 330-7835

    Fax: (859) 967-5041

    Type: Mailing

  • 160 N EAGLE CREEK DR STE 302

    LEXINGTON, KY 405092124

    Phone: (859) 967-5044

    Fax: (859) 967-5041

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250731003057INurse PractitionerKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 40743)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4183641400View full group profile
NameSpecialtyState
-KY
Hematology/Oncology, Internal MedicineKY
Physician AssistantKY
Nurse PractitionerKY
Nurse PractitionerKY
Nurse PractitionerKY
Nurse PractitionerKY
Nurse PractitionerKY
Cardiovascular Disease (Cardiology), Internal MedicineKY
H E M A T O L O G Y/ O N C O L O G YKY

Reviews

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Frequently asked questions

How is DONNA CROCKETT (APRN) identified in CMS data?
CMS-hosted NPPES data lists DONNA CROCKETT (APRN) with NPI 1174411219.
Does the file indicate DONNA CROCKETT (APRN) is practicing under active NPI?
Directory data currently reports DONNA CROCKETT (APRN) as active.
What taxonomy line describes DONNA CROCKETT (APRN)?
For research purposes, treat DONNA CROCKETT (APRN) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for DONNA CROCKETT (APRN)?
DONNA CROCKETT (APRN)'s geographic hint is London, Kentucky in our summary view.
Why does DONNA CROCKETT (APRN) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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