Latara K Craddock, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5013213 Issued in NC

Practice address

2668 Peters Creek Pkwy
Winston Salem, NC 27127-5655

Phone

(336) 200-7020

NPI assigned

Apr 28, 2020

Sex

Female

Sole proprietor

No

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

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osh Mi Physicians Group, PCGroup PAC ID 7810282191, 154 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Osh-Mi Physicians Group PC

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1033766092
  Medicare reassignment Care Compare group NPD
• Jaime E Trujillo MD PA

  • Internal Medicine Physician
  • Winston Salem, NC
  • NPI 1730301037
  Medicare reassignment NPD
• Vitae Health Medical North Carolina, PLLC

  • Internal Medicine Physician
  • Mooresville, NC
  • NPI 1265064414
  Medicare reassignment NPD
• Grace Concierge and Wellness Services, PLLC

  • Nurse Practitioner
  • Winston Salem, NC
  • NPI 1770451445
  NPD Authorized official
• Osh Mi Physicians Group, PC

  • Primary Care Clinic/Center
  • Memphis, TN
  • NPI 1720635790
  NPD

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1942821152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746724",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746724",
            "telephone_number": "312-644-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2668 PETERS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271275655",
            "telephone_number": "336-200-7020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3080 Trenwest Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033208",
            "country_code": "US",
            "telephone_number": "336-768-0496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRADDOCK",
        "first_name": "LATARA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5013213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lasheha Coxton, CADC
• Crabtree Counseling and Consulting PLLC
• Kimberlee Wynn Crabtree, MA, LCMHCA, NCC
• Rebecca M Crabtree
• Shana Alexander Crabtree, MD
• Jocelyn Ann Craft-Whitley, PA-C
• David William Craft, DPT
• Catherine Anne Craig-Wilder, RPH
• Alexis Claire Craig, MD
• Christopher Kyle Craig, PA-C

• Family Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, 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 Apr 26, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.