Individual provider Active NPI

John Walton Craddock Jr., M.D.

  • Otolaryngology Physician
  • Houston, TX
National Provider Identifier
1699752857
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
K0282 Issued in TX
Practice address
8731 Katy Fwy Ste 200
Houston, TX 77024-1735
Phone
(832) 678-8333
Fax
(713) 467-0965
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X K0282 TX
Sleep Medicine (Otolaryngology) Physician 207YS0012X K0282 TX
Facial Plastic Surgery Physician 207YS0123X K0282 TX
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X K0282 TX
Otolaryngic Allergy Physician 207YX0602X K0282 TX
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X K0282 TX
Otolaryngology Physician 207Y00000X K0282 TX Primary

Addresses

Primary practice location

8731 Katy Fwy Ste 200
Houston, TX 77024-1735

Mailing address

10740 N Gessner Rd Ste 310
Houston, TX 77064-1240
Phone (281) 897-0416

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100622000577 TX Practitioner - OtolaryngologyPractitioner - Allergy/Immunology 5193823870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Allergy/Immunology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Ear, Nose and Throat Specialists, PLLCGroup PAC ID 5799770202, 123 clinicians

Practice addresses (Care Compare)

18400 Katy Fwy
Suite 470
Houston, TX 77094-1287
Phone (281) 492-7827

Hospital & facility affiliations

  • Houston Methodist West Hospital Hospital, Houston, TX, CCN 670077

Merit-based Incentive Payment System (MIPS)

Final score
95.75 of 100Reported as group
Promoting interoperability
95
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K0282TXMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Ear, Nose & Throat Specialists, PLLC Otolaryngology CurrentSince Jan 1, 2017 Accepting new patients
Noble Anesthesia Partners, PLLC PastSince Jul 4, 2021 Accepting new patients

Locations

18400 Katy Fwy
Ste 470
Houston, TX 77094
Phone (281) 492-7827

2500 Tanglewilde St
Ste 160
Houston, TX 77063
Phone (713) 781-9660

10740 N Gessner Rd
Ste 310
Houston, TX 77064
Phone (281) 897-0416

7900 Fannin St
#1900
Houston, TX 77054
Phone (713) 791-9363

8731 Katy Fwy
Ste 200
Houston, TX 77024
Phone (713) 467-5787

9301 Pinecroft Dr
Ste 150
Shenandoah, TX 77380
Phone (281) 362-1368

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1699752857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10740 N GESSNER RD STE 310",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770641240",
            "telephone_number": "281-897-0416",
            "fax_number": "281-890-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8731 KATY FWY STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241735",
            "telephone_number": "832-678-8333",
            "fax_number": "713-467-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRADDOCK",
        "first_name": "JOHN",
        "middle_name": "WALTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "TX",
            "license": "K0282",
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "TX",
            "license": "K0282",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "TX",
            "license": "K0282",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "TX",
            "license": "K0282",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "TX",
            "license": "K0282",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "TX",
            "license": "K0282",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "K0282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.