Mrs Latara K Craddock, FNP-BC in Winston Salem, NC

Mrs Latara K Craddock, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Winston Salem, North Carolina. Her current practice location is 2668 Peters Creek Pkwy, Winston Salem, North Carolina. You can reach out to her office (for appointments etc.) via phone at (336) 200-7020.

Mrs Latara K Craddock is licensed to practice in North Carolina (license number 5013213) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1942821152.

Contact Information

	Mrs Latara K Craddock, FNP-BC
	2668 Peters Creek Pkwy, Winston Salem, NC 27127-5655
	(336) 200-7020
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Latara K Craddock
Gender	Female
Speciality	Nurse Practitioner - Family
Location	2668 Peters Creek Pkwy, Winston Salem, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1942821152
Provider Enumeration Date: 04/28/2020
Last Update Date: 04/26/2024

Medicare PECOS Information:

PECOS PAC ID: 1951721653
Enrollment ID: I20201019002485

Medical Identifiers

Medical identifiers for Mrs Latara K Craddock such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1942821152	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	5013213 (North Carolina)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Latara K Craddock allows following entities to bill medicare on her behalf.

Entity Name	Jaime E Trujillo Md Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730301037 PECOS PAC ID: 3072416049 Enrollment ID: O20040128000491

Entity Name	Osh-mi Physicians Group Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033766092 PECOS PAC ID: 7810282191 Enrollment ID: O20191118000511

Entity Name	Vitae Health Medical North Carolina Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1265064414 PECOS PAC ID: 7719317932 Enrollment ID: O20200430000531

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Latara K Craddock is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Latara K Craddock, FNP-BC Po Box 746724, Atlanta, GA 30374-6724 Ph: (312) 644-3941	Mrs Latara K Craddock, FNP-BC 2668 Peters Creek Pkwy, Winston Salem, NC 27127-5655 Ph: (336) 200-7020

Reviews and Comments

Nurse Practitioner Nurses in Winston Salem, NC

Kaila Haskins, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2085 Frontis Plaza Blvd, Winston Salem, NC 27103 Phone: 704-316-4136 Fax: 704-417-4814
Cora Robbins, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2025 Frontis Plaza Blvd Ste 100, Winston Salem, NC 27103 Phone: 336-718-6199 Fax: 336-718-6190
Mrs. Joy Lianne Justice, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2085 Frontis Plaza Blvd, Winston Salem, NC 27103 Phone: 704-316-4136 Fax: 704-417-4814
Lillykutty Abraham Modoor, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 650 Highland Ave Ste 100, Winston Salem, NC 27101 Phone: 336-607-8523 Fax: 336-773-0916
Dr. Marie Huffmaster Thomas, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3333 Silas Creek Pkwy, Winston Salem, NC 27103 Phone: 336-718-5000
Jennifer Adams, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-2878
Deborah Krist Potticary, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3333 Silas Creek Pkwy, Winston Salem, NC 27103 Phone: 336-718-7041 Fax: 336-718-9622

Mrs Latara K Craddock, FNP-BC - Medicare Nurse Practitioner in Winston Salem, NC