Patrina Nicolyn Cradic, FNP-C - Medicare Nurse Practitioner in Kingsport, TN

Patrina Nicolyn Cradic, FNP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Kingsport, Tennessee. Her current practice location is 130 W Ravine Rd, Kingsport, Tennessee. You can reach out to her office (for appointments etc.) via phone at (423) 224-4000.

Patrina Nicolyn Cradic is licensed to practice in Tennessee (license number 31156) 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 1023749538.

Contact Information

Patrina Nicolyn Cradic, FNP-C
130 W Ravine Rd,
Kingsport, TN 37660-3837
(423) 224-4000
Not Available



Physician's Profile

Full NamePatrina Nicolyn Cradic
GenderFemale
SpecialityNurse Practitioner - Family
Location130 W Ravine Rd, Kingsport, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1023749538
  • Provider Enumeration Date: 06/23/2022
  • Last Update Date: 10/04/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 6305212440
  • Enrollment ID: I20221014001640

Medical Identifiers

Medical identifiers for Patrina Nicolyn Cradic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023749538NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208M00000XHospitalist 31156 (Tennessee)Secondary
363LF0000XNurse Practitioner - Family 31156 (Tennessee)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. Patrina Nicolyn Cradic allows following entities to bill medicare on her behalf.
Entity NameSoutheastern Physician Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083835441
PECOS PAC ID: 0042307852
Enrollment ID: O20071025000571

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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. Patrina Nicolyn Cradic 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 AddressPractice Location Address
Patrina Nicolyn Cradic, FNP-C
121 Meadow Ct,
Gray, TN 37615-4276

Ph: () -
Patrina Nicolyn Cradic, FNP-C
130 W Ravine Rd,
Kingsport, TN 37660-3837

Ph: (423) 224-4000

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