Individual provider Active NPI

Mark Wade Creasey, FNP-C

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1023048303
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
34775 Issued in TN
Practice address
6515 Poplar Ave Ste 106
Memphis, TN 38119-4878
Phone
(901) 426-1090
Fax
(901) 426-1091
NPI assigned
Jul 3, 2006
Last updated
Jan 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 34775 TN Primary

Addresses

Primary practice location

6515 Poplar Ave Ste 106
Memphis, TN 38119-4878

Mailing address

206 Oxford Rd
New Albany, MS 38652-3115
Phone (662) 534-2298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231201001957 TN Practitioner - Nurse Practitioner 5890143705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11645 Hwy 51 S
Suite 103
Atoka, TN 38004-2001
Phone (901) 407-2221

6515 Poplar Ave
Suite 106
Memphis, TN 38119-4878
Phone (901) 426-1090

Merit-based Incentive Payment System (MIPS)

Final score
85.85 of 100Reported as group
Quality
82.18
Promoting interoperability
92
Improvement activities
40
Cost
74.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ortho Express Holding Company, LLC Family CurrentSince Dec 1, 2023 Accepting new patients
Orthoxpress Holdings, LLC Family CurrentSince Dec 1, 2023 Accepting new patients
Ortho Express Holding Company LLC Past Accepting new patients
Spartan Orthopaedics, LLC Past Accepting new patients

Locations

206 Oxford Rd
New Albany, MS 38652
Phone 6625342298223

11645 Highway 51 S
Ste 103
Atoka, TN 38004
Phone (901) 407-2221

6515 Poplar Ave
Ste 106
Memphis, TN 38119
Phone (901) 426-1090

Interoperability endpoints

  • Direct secure messaging: mark.creasey.1@11099.direct.athenahealth.com
  • Direct secure messaging: mark.creasey.2@11099.direct.athenahealth.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1023048303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 OXFORD RD",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523115",
            "telephone_number": "662-534-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6515 POPLAR AVE STE 106",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194878",
            "telephone_number": "901-426-1090",
            "fax_number": "901-426-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREASEY",
        "first_name": "MARK",
        "middle_name": "WADE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "34775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.