John Dominic Credico, M.D.

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

35053584 Issued in OH

Practice address

2751 Bay Park Dr
Suite 304
Oregon, OH 43616-4921

Phone

(419) 690-7611

Fax

(419) 691-1511

NPI assigned

Sep 7, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1023002938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 BAY PARK DR",
            "address_2": "SUITE 304",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436164921",
            "telephone_number": "419-690-7611",
            "fax_number": "419-691-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 BAY PARK DR",
            "address_2": "SUITE 304",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436164921",
            "telephone_number": "419-690-7611",
            "fax_number": "419-691-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREDICO",
        "first_name": "JOHN",
        "middle_name": "DOMINIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "OH",
            "license": "35053584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0601405",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Dyan Cortez, LPTA
• Taylor Jade Cortez, CPHT
• Robert Cousino
• Michelle Coutcher, LISW-S
• Jeffrey Allen Crawford, D.C.
• Feisal Crumby Jr.
• Jaime Ann Csehi, M.ED, M.A. CCC-SLP
• Maria Luisa Salvador Cuevas, M.D.
• David Babajide Da Rocha Afodu, M.D
• Isam Daboul, M.D.

• Obstetrics Physician in Oregon, OH
• Providers in Oregon, OH by specialty
• Obstetrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.