KIRSTEN EMILY STEWART CRADDOCK MD
NPI 1386219756
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Providence, RI

Q: What is Kirsten Craddock's NPI number?

The NPI number for Kirsten Craddock is 1386219756. It was assigned to this individual provider in the NPPES registry on May 26, 2021.

Q: What is Kirsten Craddock's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology with Special Qualifications in Child Neurology, with taxonomy code 2084N0402X.

Q: When was this NPI record last updated?

The NPPES record for Kirsten Craddock was last updated on July 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 60 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 26, 2021PECOS Enrolled

335R PRAIRIE AVE STE 1A, PROVIDENCE, RI 02905(401) 444-5685(401) 444-6115 Get Directions Write a Review

NPPES record last updated: July 28, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Jul 28, 2026, Jul 24, 2026, May 26, 2021 (3 updates tracked since 2021).

On this page

About Kirsten Emily Stewart Craddock Md NPPES

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

KIRSTEN EMILY STEWART CRADDOCK MD (NPI 1386219756) is an individual neurology with special qualifications in child neurology provider in Providence, Rhode Island, licensed in Rhode Island (MD21233) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Fall River.

NPPES Registry Identity

NPI1386219756

Entity TypeIndividualFemale

Primary Taxonomy2084N0402X

Provider Legal NameKIRSTEN EMILY STEWART CRADDOCKCredential: MD

Location Address335R PRAIRIE AVE STE 1AProvidence, RI 02905-2426

Mailing Address15 La Salle SqProvidence, RI 02903-1814 · (401) 444-6779 · Fax (401) 444-6912

Phone(401) 444-5685

Fax(401) 444-6115

Sole ProprietorNo

Enumeration DateMay 26, 2021

Last NPPES UpdateJuly 28, 20263 updates tracked since enumeration

NPPES CertifiedJuly 28, 2026

✔ NPI 1386219756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Neurology with Special Qualifications in Child NeurologyAllopathic & Osteopathic Physicians

Taxonomy Code2084N0402X

Licenses✔ Licensed in RI · MD21233✔ Licensed in MA · 1027401

Definition

A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.

335R PRAIRIE AVE STE 1A, Providence, RI 02905

Open in Google Maps ↗

Secondary Practice Location 1

Location 110 N Main St Ste 2CFall River, MA 02720-2130 · Phone (508) 646-3923 · Fax (508) 646-3927

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kirsten Emily Stewart Craddock Md 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 02905 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

$134.17 typical visit price

range $58.57 – $177.03

Typical copayment $33.54 (range $14.64 – $44.25)

Most-billed visit code 99204

Established Patient

$103.10 typical visit price

range $18.92 – $144.38

Typical copayment $25.77 (range $4.73 – $36.09)

Most-billed visit code 99214

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 12

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

JORDAN SONN GERVASIO

Nurse Practitioner (Family)