Paul Richard McCracken, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5546

Phone

(937) 257-1826

NPI assigned

Jun 15, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1538396809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 CREST HILL AVE",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453771558",
            "telephone_number": "937-387-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335546",
            "telephone_number": "937-257-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRACKEN",
        "first_name": "PAUL",
        "middle_name": "RICHARD",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-15",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Korah Mattamana, CRNA
• Shannel Matthews, NP
• Catherine Mauser, CNM
• Teg Wayne McBride, PSYD, ABPP
• Hampton Lee McClendon, MD, FACS
• Sean McDade, DO
• Tequilla Norrell McGahee, D.M.D.
• Ryan S McHugh, M.D.
• Ian James McIver, DO
• Charles Jeremy Mears, MD

• Independent Duty Medical Technicians in Wright Patterson Afb, OH
• Providers in Wright Patterson Afb, OH by specialty
• Independent Duty Medical Technicians in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; 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.