NPIMap

Individual provider Active NPI

Christina M Creeden, NP-C

  • Family Nurse Practitioner
  • Anderson, CA
National Provider Identifier
1073033262
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A005178 Issued in AR
Practice address
2965 East St
Anderson, CA 96007-3481
Phone
(303) 780-4865
Fax
(530) 357-0582
NPI assigned
Jun 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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 A005178 AR Primary

Addresses

Primary practice location

2965 East St
Anderson, CA 96007-3481

Mailing address

PO Box 992790
Redding, CA 96099-2790
Phone (530) 246-5710

Other identifiers 1

IdentifierTypeStateIssuer
A005178OtherARAPRN LICENSE

Other names 1

  • Christina Wammack, Dowdle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170728001601 AR Practitioner - Nurse Practitioner 7911277603 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Venvisor Health of Ar PAGroup PAC ID 8022551647, 55 clinicians
White River Health System, Inc.Group PAC ID 0143134270, 190 clinicians

Practice addresses (Care Compare)

1202 NE McClain Rd
BLDG 7
Bentonville, AR 72712-3875
Phone (203) 901-2493

1710 Harrison St
Batesville, AR 72501-7303
Phone (870) 262-1200

Hospital & facility affiliations

  • Baptist Health Medical Center Heber Springs Hospital, Heber Springs, AR, CCN 041312
  • White River Medical Center Hospital, Batesville, AR, CCN 040119

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Venvisor Health of Ar PA CurrentSince Jun 2, 2024 Accepting new patients
White River Health System, Inc. CurrentSince Aug 16, 2023 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jul 1, 2020 Accepting new patients
White River Health System, Inc. CurrentSince Aug 16, 2023 Accepting new patients
White River Health System, Inc. Current Accepting new patients

Locations

1710 Harrison St
Batesville, AR 72501
Phone (870) 262-1240

1202 NE McClain Rd
Bentonville, AR 72712
Phone (479) 278-4323

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 5

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.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1073033262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 992790",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960992790",
            "telephone_number": "530-246-5710",
            "fax_number": "870-994-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 EAST ST",
            "city": "ANDERSON",
            "state": "CA",
            "postal_code": "960073481",
            "telephone_number": "303-780-4865",
            "fax_number": "530-357-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEDEN",
        "first_name": "CHRISTINA",
        "middle_name": "M",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "A005178",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "WAMMACK, DOWDLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anderson, CA

Sources for this page

Verify at the official NPI Registry.