Individual provider Active NPI

Anne Briton Craddock Wynn, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Memphis, TN
National Provider Identifier
1134462666
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
55810 Issued in TN
Practice address
880 Madison Ave
Memphis, TN 38103-3409
Phone
(901) 545-8535
NPI assigned
Apr 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 55810 TN Primary

Addresses

Primary practice location

880 Madison Ave
Memphis, TN 38103-3409

Mailing address

PO Box 5154
Memphis, TN 38101-5154
Phone (901) 275-3725

Other names 1

  • Anne Briton Craddock Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20190621002204 TN Practitioner - Endocrinology 6709024425 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
University of Tennessee, HSC, College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Regional One Physicians IncGroup PAC ID 5698993418, 314 clinicians

Practice addresses (Care Compare)

6555 Quince Rd
Memphis, TN 38119-8202
Phone (901) 515-3150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.97 of 100Reported as group
Quality
64.58
Improvement activities
40
Cost
77.33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55810TNMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Lebonheur Pediatric Specialists, Inc. CurrentSince Nov 11, 2019 Accepting new patients
Ut Regional One Physicians Inc CurrentSince Jul 1, 2019 Accepting new patients
Ut Regional One Physicians Inc CurrentSince Jul 1, 2019 Accepting new patients

Locations

6555 Quince Rd
Memphis, TN 38119
Phone (901) 515-3150

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

890 Madison Ave
Memphis, TN 38103
Phone (865) 776-7348

880 Madison Ave
Memphis, TN 38103
Phone (901) 515-3500

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

Interoperability endpoints

  • Direct secure messaging: awynn23021@mlh.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1134462666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5154",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381015154",
            "telephone_number": "901-275-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033409",
            "telephone_number": "901-545-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "ANNE",
        "middle_name": "BRITON CRADDOCK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TN",
            "license": "55810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "CRADDOCK",
            "middle_name": "BRITON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.