Mariann M Craddock, NP
Individual provider Active NPI Family Nurse Practitioner · Live Oak, TX
NPI 1295019503 · NPPES record last updated Sep 29, 2025
Key facts
- NPI
- 1295019503
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP120818 (TX)
- Practice address
- 12881 N Ih 35
Live Oak, TX 78233-2966 - Phone
- (210) 742-6555
- Fax
- (732) 587-5486
- NPI assigned
- Oct 5, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Physician Primecare, Inc
Practice addresses (Care Compare)
105 Falls CT
Suite 100
Boerne, TX 78006-2986
Phone (830) 249-3800
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120808000479 | TX | Practitioner - Nurse Practitioner | 7810143781 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 661440 | TX | MD | Nurse Practitioner |
| AP120818 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Development Inc. | Current | Accepting new patients | |
| Hillside Primary Care PLLC | Nurse Practitioner | Current |
Accepting new patients |
| Physician Primecare, Inc | Current |
Accepting new patients | |
| Lone Star Extensivists PLLC | Past |
Accepting new patients | |
| Hill Country Medicine | Past |
Accepting new patients | |
| Complete Care Partners LLC | Past |
Accepting new patients |
Locations
105 Falls Ct
Ste 100
Boerne, TX 78006
Phone (830) 249-3800
1300 Dacy Ln
Kyle, TX 78640
Phone (512) 262-6020
1300 Dacy Ln
Ofc
Kyle, TX 78640
12881 N Interstate 35
Live Oak, TX 78233
Phone (210) 742-6552
12881 Toepperwein Rd
#I35
Live Oak, TX 78233
12410 Toepperwein Rd
#O
Live Oak, TX 78233
Phone (210) 659-4425
790 Generations Dr
Ste 405
New Braunfels, TX 78130
Phone (210) 767-2549
741 Generations Dr
Ste 215
New Braunfels, TX 78130
911 Castroville Rd
San Antonio, TX 78237
Phone (210) 436-7402
2961 Mossrock
San Antonio, TX 78230
Phone (210) 731-4800
200 Evans St
Uvalde, TX 78801
Phone (830) 278-7105
908 Evans St
Uvalde, TX 78801
Phone (830) 278-3765
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- https://api.platform.athenahealth.com/4057/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 661440 | TX | |
| Family Nurse Practitioner | 363LF0000X | AP120818 | TX | Yes |
Addresses
Primary practice location
12881 N Ih 35
Live Oak, TX 78233-2966
Mailing address
2961 Mossrock
San Antonio, TX 78230-5119
Phone (210) 731-4800
Other practice location 1
105 Falls Ct Ste 100
Boerne, TX 78006-2986
Phone (830) 249-3800
Other providers in Live Oak, TX
- Council Oaks Community Options LTD.
- Council Oaks Community Options LTD.
- Council Oaks Community Options, LTD.
- Council Oaks Community Options, LTD.
- Naomi Cousins-Bailey
- Kelly L Crain
- Sabrina Crane
- Susan Ann Crockett
- Drew Stephen Czerminski
- Rhonda Claudine D'Lorm
All providers in Live Oak, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.