Creosote Total Health PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CREOSOTE TOTAL HEALTH PC

Practice address

8380 S Kyrene Rd # D-103
Tempe, AZ 85284-2120

Phone

(480) 269-3208

Fax

(480) 674-1295

NPI assigned

Nov 15, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Simon Sheard, DONPI 1083926877

Title

Physician/Owner

Phone

(480) 269-3208

Specialties & licenses 1

Addresses

Other names 1

• Creosote Total Health Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Simon Sheard, D.O.

  • Family Medicine Physician
  • Tempe, AZ
  • NPI 1083926877
  Medicare reassignment NPD Authorized official
• Kiana Rose Ruch, ND

  • Naturopath
  • Tempe, AZ
  • NPI 1811692437
  NPD (past)
• Suzanne R Tariot Sheard, D.O.

  • Psychiatry Physician
  • Chandler, AZ
  • NPI 1366762049
  NPD (past)

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1043928476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8380 S KYRENE RD # D-103",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852842120",
            "telephone_number": "480-269-3208",
            "fax_number": "480-674-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 S KYRENE RD # D-103",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852842120",
            "telephone_number": "480-269-3208",
            "fax_number": "480-674-1295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREOSOTE TOTAL HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-15",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "SHEARD",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "480-269-3208",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creosote Total Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Creosote Total Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caryn Leigh Crecelius, PHARM. D
• Credo Minds Behavioral Health LLC
• Jacob Eli Cree
• Karlee Crenshaw, RBT
• Creosote Psychiatry PLC
• Briana Crespo
• Crestview Child Counseling, LLC
• Crestview Pharmacy Services LLC
• Kourtney Crier, PSY.D.
• Tera Crisalida, PA

• Family Medicine Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.