NPIMap

Individual provider Active NPI

Durrett Craddock, MD

  • Diagnostic Radiology Physician
  • Louisville, KY
National Provider Identifier
1700884137
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01058855A Issued in KY
Practice address
200 E Chestnut St
Louisville, KY 40202-1831
Phone
(502) 629-7601
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01058855A KY Primary

Addresses

Primary practice location

200 E Chestnut St
Louisville, KY 40202-1831

Mailing address

234 E Gray St
Suite 850
Louisville, KY 40202-1900
Phone (502) 585-1735

Other identifiers 4

IdentifierTypeStateIssuer
000000308613OtherKYBC BS
50005977OtherKYPASSPORT
000000330651OtherKYBC BS
64054075MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040803000684 KY Practitioner - Diagnostic Radiology 0345133799 Reassigns benefits to 1 organization
I20240807004254 IN Practitioner - Diagnostic Radiology 0345133799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Kentucky College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Imaging Alliance of Louisville PSCGroup PAC ID 1951214220, 25 clinicians

Practice addresses (Care Compare)

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 629-7601

315 E Broadway
Louisville, KY 40202-3700
Phone (502) 585-1735

3901 Dutchmans LN
Suite 101
Louisville, KY 40207-4726
Phone (502) 896-2120

4420 Dixie Hwy
Suite 108
Louisville, KY 40216-2986
Phone (502) 585-1735

4915 Norton Healthcare Blvd
Louisville, KY 40241-2860
Phone (502) 585-1735

4960 Norton Healthcare Blvd
Louisville, KY 40241-2831
Phone (502) 446-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.41 of 100Reported as group
Quality
92.64
Improvement activities
40
Cost
68.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01058855AKYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Imaging Alliance of Louisville PSC Diagnostic Radiology CurrentSince Jul 1, 2004 Accepting new patients
Open MRI, LLC Past Accepting new patients

Locations

Dept 8054
Carol Stream, IL 60122

101 Hospital Blvd
Jeffersonvlle, IN 47130
Phone (812) 206-8196

201 Cathedral Mnr
Bardstown, KY 40004
Phone (502) 348-3923

309 11th St
Carrollton, KY 41008
Phone (502) 732-3241

315 E Broadway
Louisville, KY 40202
Phone (502) 272-5331

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

4915 Norton Healthcare Blvd
Ste 101
Louisville, KY 40241

3901 Dutchmans Ln
Ste 101
Louisville, KY 40207
Phone (502) 896-2120

234 E Gray St
Ste 850
Louisville, KY 40202

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1700884137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 E GRAY ST",
            "address_2": "SUITE 850",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021900",
            "telephone_number": "502-585-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021831",
            "telephone_number": "502-629-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRADDOCK",
        "first_name": "DURRETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "01058855A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "000000308613",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50005977",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "000000330651",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64054075",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.