Creighton E Shute, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO.000309 Issued in LA

Practice address

5750 Johnston St Ste 101
Lafayette, LA 70503-5334

Phone

(337) 703-0703

Fax

(337) 703-0704

NPI assigned

Jul 7, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 14, 2021 through Oct 14, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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.

• Lafayette Health Ventures, Inc

  • Neurology Physician
  • Lafayette, LA
  • NPI 1568492841
  NPD (past)

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1073742425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 JOHNSTON ST STE 101",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705035334",
            "telephone_number": "337-703-0703",
            "fax_number": "337-703-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 JOHNSTON ST STE 101",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705035334",
            "telephone_number": "337-703-0703",
            "fax_number": "337-703-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTE",
        "first_name": "CREIGHTON",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-07",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "LA",
            "license": "DO.000309",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "DO.000309",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "DO.000309",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "LA",
            "license": "DO.000309",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shine on the Spectrum
• Donald D Short, LPC, LMFT
• Josh Anthony Showalter, M.D.
• Jishna Shrestha, MD
• Samuel Henderson Shuffler, MD
• Christin Ann Sias, HAIR LOSS SPECIALIST
• Ivy Desirae Bennett Sias, M.S., NCC, LPC
• Jonterra Sias
• Tanya Sias, MS CCC SLP
• Galeno Sibilia, MD

• Family Medicine Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.