Lisa Credo, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

321372 Issued in LA

Practice address

800 Marshall St # 653
Little Rock, AR 72202-3510

Phone

(501) 364-1100

NPI assigned

May 4, 2009

Last updated

Aug 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Advanced Breastfeeding Medicine of New Orleans LLC

  • Pediatrics Physician
  • Metairie, LA
  • NPI 1730792110
  Authorized official Same address or phone

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

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1093949117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 METAIRIE RD",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700015215",
            "telephone_number": "504-358-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MARSHALL ST # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023510",
            "telephone_number": "501-364-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREDO",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-04",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "321372",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "321372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Brooke Creamer, BT
• Create Healing Counseling Services PLLC
• Create Space Counseling
• Creating Space Therapy, LLC
• Creative Practice, LLC
• Paul W Creel, OTR/L CHT
• Akelia Terrelll Creggett
• Erin Rachel Creighton, MD
• Thomas Alexander Crespo
• Jessica Cress

• Pediatrics Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.