Individual provider Active NPI

Cacee V Raddle

  • Family Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1124740428
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
221844 Issued in AR
Practice address
1 Childrens Way # 512-1
Little Rock, AR 72202-3500
Phone
(501) 364-1100
Fax
(501) 364-4082
NPI assigned
Sep 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 221844 AR Primary

Addresses

Primary practice location

1 Childrens Way # 512-1
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Other names 1

  • Cacee V Crumpton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221102003418 AR Practitioner - Nurse Practitioner 6608243746 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Current Accepting new patients
Arkansas Children'S Hospital CurrentSince Jun 26, 2024 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jun 26, 2024 Accepting new patients
Paul W Davis MD PA CurrentSince Sep 9, 2022 Accepting new patients
Arkansas Childrens Hospital CurrentSince Jun 26, 2024 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jun 26, 2024 Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients

Locations

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
#5121
Little Rock, AR 72202
Phone (501) 364-5262

1 Childrens Way
Ste 653
Little Rock, AR 72202

7400 Dollarway Rd
Ste A
White Hall, AR 71602
Phone (870) 247-8900

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1124740428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 512-1",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADDLE",
        "first_name": "CACEE",
        "middle_name": "V",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "221844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CACEE",
            "last_name": "CRUMPTON",
            "middle_name": "V",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.