Charles A Craddock III

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Practice address

5135 E 112TH St
Garfield Heights, OH 44125-2729

Phone

(216) 278-4717

NPI assigned

Dec 9, 2024

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

Practice roles

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.

• Alpha Alliance Care LLC

  • Developmentally Disabled Services Day Training Agency
  • Garfield Heights, OH
  • NPI 1285437137

  Day Training, Developmentally Disabled Services

  NPD Authorized official

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1962218586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5135 E 112TH ST",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441252729",
            "telephone_number": "216-278-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5135 E 112TH ST",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441252729",
            "telephone_number": "216-278-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRADDOCK",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Copeland
• Travis Copley
• Matthew J Corbett, LISW-SUPV
• Cosiva Health
• Brian Matthew Cost, DO
• Mary Emma Crenshaw, LISW,LICDC
• Darlene Crockett, STNA
• Paul Crosby Sr., QMHS
• Mone Cross, RN
• Melissa Crouse, DPT

• All providers in Garfield Heights, OH
• Developmentally Disabled Services Day Training Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.