Individual provider Active NPI

William P Cravens, M.D.

  • Family Medicine Physician
  • Fulton, MO
National Provider Identifier
1104802479
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R7F41 Issued in MO
Practice address
850 West Hospital Drive
Suite a
Fulton, MO 65251
Phone
(573) 592-0337
Fax
(573) 592-0711
NPI assigned
Dec 19, 2005
Last updated
Mar 11, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R7F41 MO Primary
Emergency Medicine Physician 207P00000X R7F41 MO

Addresses

Primary practice location

850 West Hospital Drive
Suite a
Fulton, MO 65251

Mailing address

PO Box 6067
Fulton, MO 65251-6067
Phone (573) 592-0337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031204000772 MO Practitioner - Family PracticePractitioner - Internal MedicinePractitioner - Emergency Medicine 1951206978 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Camden Emergency Group LLC Emergency Medicine CurrentSince May 1, 2012 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Sep 1, 2020 Accepting new patients
Healthmont of Missouri LLC Past Accepting new patients
Callaway Emergency Physicians, LLC Emergency Medicine Past Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1104802479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6067",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652516067",
            "telephone_number": "573-592-0337",
            "fax_number": "573-592-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 WEST HOSPITAL DRIVE",
            "address_2": "SUITE A",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "65251",
            "telephone_number": "573-592-0337",
            "fax_number": "573-592-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVENS",
        "first_name": "WILLIAM",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R7F41",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "R7F41",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, MO

Sources for this page

Verify at the official NPI Registry.