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GREGORY JAMES CRADDOCK DO NPI 1912004862


NPI Information

NPI: 1912004862
Provider Name: GREGORY JAMES CRADDOCK, DO
Classification: Neuromusculoskeletal Medicine & OMM - 204D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1225 MARTHA CUSTIS DR
STE C-7
ALEXANDRIA, VA
ZIP 22302
Phone: (703) 998-6760
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Gregory James Craddock, DO is a neuromusculoskeletal medicine omm in Alexandria, VA. The provider is the Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. Gregory James Craddock, DO NPI is 1912004862. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1225 MARTHA CUSTIS DR
STE C-7
ALEXANDRIA, VA
ZIP 22302-000
Phone: (703) 998-6760

The NPI 1912004862 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1204D00000XNeuromusculoskeletal Medicine & OMM0102201175VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H43738MEDICARE UPINVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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