William G. Craddock

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

0000000650 Issued in TN

Legal business name

WILLIAM G. CRADDOCK

Practice address

104 Garner Ave
Madison, TN 37115-2830

Phone

(615) 612-0087

Fax

(615) 612-0587

NPI assigned

Aug 23, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Pete L. Clinard, ATS, CRTS

Title

Manager

Phone

(615) 612-0087

Specialties & licenses 2

Addresses

Other identifiers 7

Other names 1

• Advanced Health Care Doing business as

Locations

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1477660967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 GARNER AVE",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371152830",
            "telephone_number": "615-612-0087",
            "fax_number": "615-612-0587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 GARNER AVE",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371152830",
            "telephone_number": "615-612-0087",
            "fax_number": "615-612-0587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM G. CRADDOCK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "CLINARD",
        "authorized_official_first_name": "PETE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "615-612-0087",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ATS, CRTS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": "0000000650",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "TN",
            "license": "0000000650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2179198",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3035094",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9027403600",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452195",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "55770104",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100005360",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "3035094",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emma Whatton, CRNA
• Ireland White
• Kari White, OT
• Kali Whitson
• Christine Marie Wilcher, BA
• Donald Tyler Williams, BS, RBT
• James Kenneth Williams, DDS
• Jason Michael Williams
• Karen Williams
• Kenny Lee Williams

• Customized Equipment (DME) in Madison, TN
• Providers in Madison, TN by specialty
• Customized Equipment (DME) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.