Individual provider Active NPI

Patricia Bowden Craig, GNP-C

  • Gerontology Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1457360273
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
224969 Issued in TX
Practice address
10670 N Central Expy Ste 120
Dallas, TX 75231-2130
Phone
(214) 692-8541
Fax
(214) 242-1035
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 224969 TX Primary

Addresses

Primary practice location

10670 N Central Expy Ste 120
Dallas, TX 75231-2130

Mailing address

10670 N Central Expy Ste 120
Dallas, TX 75231-2130
Phone (214) 692-8541

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141030001210 TX Practitioner - Nurse Practitioner 6305067687

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224969TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Residential Visits Association Past Accepting new patients
Consultants in Radiology PA PastSince Aug 1, 2014 Accepting new patients

Organizations & group practices 2

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1457360273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10670 N CENTRAL EXPY STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752312130",
            "telephone_number": "214-692-8541",
            "fax_number": "214-242-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10670 N CENTRAL EXPY STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752312130",
            "telephone_number": "214-692-8541",
            "fax_number": "214-242-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "PATRICIA",
        "middle_name": "BOWDEN",
        "credential": "GNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "224969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.