Harvey R Craddock, SURGICAL ASSISTANT

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

License

SA011 Issued in KY

Practice address

258 Corvin LN
Elizabethtown, KY 42701-5771

Phone

(270) 317-4827

Fax

(270) 234-8558

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1902822844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6292",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427026292",
            "telephone_number": "270-317-4827",
            "fax_number": "270-234-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 CORVIN LN",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427015771",
            "telephone_number": "270-317-4827",
            "fax_number": "270-234-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRADDOCK",
        "first_name": "HARVEY",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "SURGICAL ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "KY",
            "license": "SA011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Keeling Cowley, OTR
• John Steven Cox
• Lisa Marie Cox
• Malorie Autumn Cox
• CPS - Elizabethtown ASC LLC
• Caylen T Craft
• Marcis A Craig, MD
• Jessicca N Cranmer, M.ED., LPCC
• Shannon Kay Crase
• Carlie Crawford

• Surgical Technologist in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Surgical Technologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.