Creekside at Elfindale

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

BUS-0017337 Issued in MO

Legal business name

CREEKSIDE AT ELFINDALE

Doing business as

Creekside at Elfindale

Practice address

1601 S Fort Ave
Springfield, MO 65807-8430

Phone

(417) 831-3828

Fax

(417) 831-3899

NPI assigned

Jun 10, 2017

Organization subpart

No

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

Authorized official

Name

Jack D Vetter

Title

Ceo

Phone

(402) 895-3932

Specialties & licenses 1

Addresses

Other names 1

• Creekside at Elfindale Doing business as

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

{
    "created_epoch": "1497052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497052800000",
    "number": "1033648274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20220 HARNEY ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680222063",
            "telephone_number": "402-885-6120",
            "fax_number": "402-895-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 S FORT AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658078430",
            "telephone_number": "417-831-3828",
            "fax_number": "417-831-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE AT ELFINDALE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-10",
        "last_updated": "2017-06-10",
        "status": "A",
        "authorized_official_last_name": "VETTER",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "402-895-3932"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "BUS-0017337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creekside at Elfindale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Creative Collaborative Therapy LLC
• Creative Counseling Center
• Creative Renewal & Resolutions, LLC
• Sophia Grace Creeden, STUDENT
• Hannah Shirley Creek, PA-C
• Chelsea Crespo, PA
• Lisa Crick
• Crighton Olive Dunn Surgical Group Inc
• John C Crighton, MD
• Mary Nanette Crighton, MD

• Assisted Living Facility in Springfield, MO
• Providers in Springfield, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.