NPIMap

Organization Active NPI

Creative Potential LLC

Doing business as Creative Potential

  • Personal Care Attendant
  • Uncasville, CT
National Provider Identifier
1114504941
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Legal business name
CREATIVE POTENTIAL LLC
Doing business as
Creative Potential
Practice address
912 Norwich New London Tpke Ste 5
Uncasville, CT 06382-1908
Phone
(860) 848-0514
Fax
(860) 848-0523
NPI assigned
Mar 26, 2021
Last updated
Jan 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Authorized official

Name
Mrs. Sierra R DavisNPI 1972297935
Title
Owner
Phone
(860) 848-0514

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X NU Primary

Addresses

Primary practice location

912 Norwich New London Tpke Ste 5
Uncasville, CT 06382-1908

Mailing address

915 Norwich New London Tpke
Unit 5
Uncasville, CT 06382-1600
Phone (860) 848-0514

Other names 1

  • Creative Potential Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Creative Potential5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

912 Norwich New London Tpke
Ste 5
Uncasville, CT 06382
Phone (860) 848-0514

915 Norwich New London Tpke
Unit 5
Uncasville, CT 06382

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1114504941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 NORWICH NEW LONDON TPKE",
            "address_2": "UNIT 5",
            "city": "UNCASVILLE",
            "state": "CT",
            "postal_code": "063821600",
            "telephone_number": "860-848-0514",
            "fax_number": "860-848-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 NORWICH NEW LONDON TPKE STE 5",
            "city": "UNCASVILLE",
            "state": "CT",
            "postal_code": "063821908",
            "telephone_number": "860-848-0514",
            "fax_number": "860-848-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE POTENTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-26",
        "last_updated": "2022-01-04",
        "certification_date": "2021-11-11",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SIERRA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-848-0514",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creative Potential",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Creative Potential",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Uncasville, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.