Jennifer Carter Credle, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P2215 Issued in NC

Practice address

3100 NC Hwy 55
Suite 102
Cary, NC 27519-8427

Phone

(919) 363-5000

Fax

(919) 363-5346

NPI assigned

Jan 9, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dynamic Therapy, Inc.

  • Speech-Language Pathologist
  • Apex, NC
  • NPI 1003843442
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1013066414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 RIDGEPINE DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275027934",
            "telephone_number": "919-363-5000",
            "fax_number": "919-363-5346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 NC HWY 55",
            "address_2": "SUITE 102",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275198427",
            "telephone_number": "919-363-5000",
            "fax_number": "919-363-5346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREDLE",
        "first_name": "JENNIFER",
        "middle_name": "CARTER",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "2215",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P2215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "0786I",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cranial Technologies Inc
• Suzanne Craven, PA
• Krystle M Craver, DPT
• Brandon Cray
• Kelly Creasman, BCBA
• Brad J Creehan, D.C.
• Heather M Creehan, D.C.
• Kristen Kelly Crenshaw, DPT, PT, ATC, CSCS
• Crescent Family Practice, P.a.
• Crescent Family Practice, P.a.

• Physical Therapist in Cary, NC
• Providers in Cary, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.