Individual provider Active NPI

Chandler Cracraft, APRN, FNP

  • Family Nurse Practitioner
  • Rogers, AR
National Provider Identifier
1700545969
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
214972 Issued in AR
Practice address
2708 S Rife Medical LN Ste 210
Rogers, AR 72758-1456
Phone
(479) 338-3888
NPI assigned
Dec 14, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 214972 AR Primary

Addresses

Primary practice location

2708 S Rife Medical LN Ste 210
Rogers, AR 72758-1456

Mailing address

2708 S Rife Medical LN Ste 210
Rogers, AR 72758-1456

Other practice location 1

14405 Fox Rd
Rogers, AR 72756-7759
Phone (479) 640-6504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20220223002039 AR Practitioner - Nurse Practitioner 0446644181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, 314 clinicians

Practice addresses (Care Compare)

2708 S Rife Medical LN
Suite 210
Rogers, AR 72758-1456
Phone (479) 338-3888

Hospital & facility affiliations

  • Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Feb 20, 2022 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Feb 20, 2022 Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

2708 S Rife Medical Ln
Ste 210
Rogers, AR 72758
Phone (479) 338-3888

Organizations & group practices 3

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": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1700545969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 S RIFE MEDICAL LN STE 210",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 S RIFE MEDICAL LN STE 210",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581456",
            "telephone_number": "479-338-3888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14405 Fox Rd",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727567759",
            "country_code": "US",
            "telephone_number": "479-640-6504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRACRAFT",
        "first_name": "CHANDLER",
        "credential": "APRN, FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-14",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "214972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.