Individual provider Active NPI

Caitlin Craddock Field, PA-C

  • Physician Assistant
  • Baton Rouge, LA
National Provider Identifier
1417408279
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
303836 Issued in LA
Practice address
13348 Coursey Blvd Ste D
Baton Rouge, LA 70816-4970
Phone
(225) 442-7939
Fax
(225) 777-1040
NPI assigned
Oct 17, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 303836 LA Primary

Addresses

Primary practice location

13348 Coursey Blvd Ste D
Baton Rouge, LA 70816-4970

Mailing address

130 Desiard St Ste 355
Monroe, LA 71201-7363
Phone (318) 807-7875

Other practice location 1

180 N 5th St
Ponchatoula, LA 70454-2532
Phone (985) 370-7546

Other names 1

  • Caitlin Victoria Craddock Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20161130000143 LA Practitioner - Physician Assistant 2062792526 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Dermatology of Ponchatoula LLCGroup PAC ID 6103126974, 9 clinicians

Practice addresses (Care Compare)

180 N 5TH St
Ponchatoula, LA 70454-2532
Phone (985) 370-7546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Oct 15, 2018 Accepting new patients
Ochsner Clinic LLC CurrentSince Oct 15, 2018 Accepting new patients
Affinity Health Group, LLC CurrentSince Jun 14, 2021 Accepting new patients
Affinity Health Group, LLC CurrentSince Jun 14, 2021 Accepting new patients

Locations

13348 Coursey Blvd
Ste D
Baton Rouge, LA 70816
Phone (225) 442-7939

2408 Broadmoor Blvd
Ste 2
Monroe, LA 71201
Phone (318) 807-0525

130 Desiard St
Ste 355
Monroe, LA 71201
Phone (318) 807-7875

1514 Jefferson Hwy
New Orleans, LA 70121

Organizations & group practices 6

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1417408279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 DESIARD ST STE 355",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017363",
            "telephone_number": "318-807-7875",
            "fax_number": "318-812-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13348 COURSEY BLVD STE D",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708164970",
            "telephone_number": "225-442-7939",
            "fax_number": "225-777-1040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Ponchatoula",
            "state": "LA",
            "postal_code": "704542532",
            "country_code": "US",
            "telephone_number": "985-370-7546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIELD",
        "first_name": "CAITLIN",
        "middle_name": "CRADDOCK",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "303836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "CRADDOCK",
            "middle_name": "VICTORIA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.