Individual provider Active NPI

Ryan Craddock, D.O.

  • Hospitalist Physician
  • Princeton, WV
National Provider Identifier
1649666488
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
3295 Issued in WV
Practice address
122 12TH St
Princeton, WV 24740
Phone
(304) 487-7047
NPI assigned
Apr 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3295 WV
Hospitalist Physician 208M00000X 3295 WV Primary

Addresses

Primary practice location

122 12TH St
Princeton, WV 24740

Mailing address

118 12TH Street Ext
Princeton, WV 24740-2352

Other practice location 1

500 Cherry St
Bluefield, WV 24701-3306
Phone (304) 327-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1649666488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 12TH ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "24740",
            "telephone_number": "304-487-7047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Cherry St",
            "address_purpose": "LOCATION",
            "city": "Bluefield",
            "state": "WV",
            "postal_code": "247013306",
            "country_code": "US",
            "telephone_number": "304-327-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRADDOCK",
        "first_name": "RYAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-08",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "3295",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WV",
            "license": "3295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

Verify at the official NPI Registry.