DR. ROGER D CRADDOCK D.D.S. - NPI 1114056694

Q: What is Roger Craddock's NPI number?

The NPI number for Roger Craddock is 1114056694. It was assigned to this individual provider in the NPPES registry on March 2, 2007.

Q: What is Roger Craddock's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Q: When was this NPI record last updated?

The NPPES record for Roger Craddock was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Roger D Craddock D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ROGER D CRADDOCK D.D.S. (NPI 1114056694) is an individual periodontics provider in Memphis, Tennessee, licensed in Tennessee (6912) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114056694

Entity TypeIndividualMale

Primary Taxonomy1223P0300X

Provider Legal NameDR. ROGER D CRADDOCKCredential: D.D.S.

Location Address6268 POPLAR AVEMemphis, TN 38119-4713

Mailing Address6268 Poplar AveMemphis, TN 38119-4713 · (901) 761-3770 · Fax (901) 761-3775

Phone(901) 761-3770

Fax(901) 761-3775

Sole ProprietorNo

Enumeration DateMarch 2, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1114056694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in TN · 6912

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

6268 POPLAR AVE, Memphis, TN 38119

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Roger D Craddock D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38119 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PERIODONTAL ASSOCIATES OF MEMPHIS

Dentist (Periodontics)