Individual provider Active NPI

Michelle Marie Craven, MD

  • Pediatric Anesthesiology Physician
  • Fort Worth, TX
National Provider Identifier
1225237365
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
P3617 Issued in TX
Practice address
801 7TH Ave
Fort Worth, TX 76104-2733
Phone
(682) 885-4054
Fax
(682) 885-7497
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X P3617 TX Primary

Addresses

Primary practice location

801 7TH Ave
Fort Worth, TX 76104-2733

Mailing address

PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-1855

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcraven13132@CookChildrens.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120917000293 TX Practitioner - AnesthesiologyPractitioner - Pediatric Medicine 3375708316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pediatric Medicine
Education
University of Texas Medical School at San Antonio, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook Childrens Physician NetworkGroup PAC ID 7719884584, 307 clinicians

Practice addresses (Care Compare)

801 7TH Ave
Fort Worth, TX 76104-2733
Phone (682) 885-4095

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network CurrentSince Nov 1, 2012 Accepting new patients
Cook Children'S Physician Network CurrentSince Nov 1, 2012 Accepting new patients
Cook Children'S Surgery Center, LLC Past Accepting new patients
Cook Children'S Medical Center Past Accepting new patients

Locations

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

6316 Precinct Line Rd
Ste B
Hurst, TX 76054
Phone (817) 605-2950

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: mcraven13132@cookchildrens.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1225237365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 7TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042733",
            "telephone_number": "682-885-4054",
            "fax_number": "682-885-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVEN",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "TX",
            "license": "P3617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcraven13132@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "801 7th Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.