Alisa Rochelle Craddock, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F02241056 Issued in NC

Practice address

906 N US Highway 421
Clinton, NC 28328-0410

Phone

(910) 592-1462

Fax

(910) 808-1040

NPI assigned

Feb 23, 2010

Last updated

Oct 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Geriatric Consultants PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Hickory, NC
  • NPI 1801478086
  Medicare reassignment NPD
• Goshen Medical Center, Incorporated

  dba Goshen Medical Center - Duplin

  • Federally Qualified Health Center (FQHC)
  • Kenansville, NC
  • NPI 1962124974
  Medicare reassignment NPD
• Alternative Staffing

  • Home Health Agency
  • Clinton, NC
  • NPI 1124395058
  NPD (past) Authorized official
• Goshen Medical Center Incorporated

  dba Goshen Medical Center - Clinton Mobile Unit

  • Federally Qualified Health Center (FQHC)
  • Clinton, NC
  • NPI 1073638557
  NPD
• Goshen Medical Center Incorporated

  dba GMC Pharmacy at Rockingham

  • Federally Qualified Health Center (FQHC)
  • Rockingham, NC
  • NPI 1457181323
  NPD

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1679895296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "FAISON",
            "state": "NC",
            "postal_code": "283410187",
            "telephone_number": "910-267-2042",
            "fax_number": "855-996-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 N US HIGHWAY 421",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283280410",
            "telephone_number": "910-592-1462",
            "fax_number": "910-808-1040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 N Railroad St",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "NC",
            "postal_code": "283981830",
            "country_code": "US",
            "telephone_number": "910-590-3006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRADDOCK",
        "first_name": "ALISA",
        "middle_name": "ROCHELLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-23",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F02241056",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "178364",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• County of Sampson (Sampson County Health Department)
• County of Sampson (Sampson County EMS & Rescue)
• County of Sampson (Sampson County Health Department)
• Samuel Nelson Cowherd, DDS
• Ronald Paul Cox, M.A., LPC, LCAS, SAP
• Margaret Crampton
• Anna Cui
• Cumberland County Health System Inc (CFV Ophthalmology-Clinton)
• Cumberland County Hospital System Inc (CFV Ophthalmology-Clinton)
• Cumberland County Hospital System Inc (Cape Fear Valley Huff Orthopedics and Sports Medicine)

• Family Nurse Practitioner in Clinton, NC
• Providers in Clinton, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.