NPIMap

Individual provider Active NPI

John D. Creasy, M.D.

  • Diagnostic Radiology Physician
  • Kingsport, TN
National Provider Identifier
1124029244
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
31555 Issued in TN
Practice address
130 W Ravine Rd
Kingsport, TN 37660-3810
Phone
(423) 968-1144
Fax
(423) 968-3453
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2026013073 MO
Diagnostic Radiology Physician 2085R0202X 81937 MN
Diagnostic Radiology Physician 2085R0202X 31555 TN Primary

Addresses

Primary practice location

130 W Ravine Rd
Kingsport, TN 37660-3810

Mailing address

3053 W State St
Bristol, TN 37620-1720
Phone (423) 968-1144

Other practice location 1

PO Box 5010
Minot, ND 58702-5010
Phone (701) 418-8000

Other practice location 2

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

Other practice location 3

6000 Hospital Dr
Hannibal, MO 63401-6887
Phone (573) 248-5300

Other identifiers 7

IdentifierTypeStateIssuer
300108603OtherPGA (RR MEDICARE)
64008402MedicaidKY
3140729OtherTNBCBS
R06903OtherTNJOHN DEERE
200008400MedicaidWV
3844447MedicaidTN
7205066MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CT, IA, ND, MO, NM, IL7 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
I20180921002162 NC Practitioner - Diagnostic Radiology 1557393386 Reassigns benefits to 11 organizations
I20260331002490 CT Practitioner - Diagnostic Radiology 1557393386 Reassigns benefits to 1 organization
I20260331003671 IA Practitioner - Diagnostic Radiology 1557393386 Reassigns benefits to 3 organizations
I20260427002400 ND Practitioner - Diagnostic Radiology 1557393386 Reassigns benefits to 1 organization
I20260514001624 MO Practitioner - Diagnostic Radiology 1557393386 Reassigns benefits to 1 organization
I20260623002242 NM Practitioner - Diagnostic Radiology 1557393386 Reassigns benefits to 1 organization
I20260624001270 IL Practitioner - Radiation Oncology 1557393386 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Alabama School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Iowa Regional Medical Center IncGroup PAC ID 3870496417, 259 clinicians
Trinity Health of New England Provider Network Organization IncGroup PAC ID 0941113567, 644 clinicians
Trinity HealthGroup PAC ID 7911816020, 292 clinicians
Gaston Radiology PAGroup PAC ID 4082680806, 29 clinicians
Radiology Consultants of Iowa PLCGroup PAC ID 3577467851, 73 clinicians
Columbus Regional Healthcare SystemGroup PAC ID 2961312228, 120 clinicians
Scotland Memorial Hospital, IncGroup PAC ID 0648208504, 259 clinicians

Practice addresses (Care Compare)

10230 Enclave Cir
Concord, NC 28027-7841
Phone (319) 768-1170

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

2305 37TH Ave SW
Minot, ND 58701-7669
Phone (701) 418-8000

336 Burtonwood Dr
Gastonia, NC 28054-4054
Phone (704) 867-8021

4739 Binfords Ridge Rd
Charlotte, NC 28226-4007
Phone (319) 364-0121

500 Jefferson St
Whiteville, NC 28472-3634
Phone (910) 642-8011

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (910) 610-4172

Hospital & facility affiliations

  • Caromont Regional Medical Center Hospital, Gastonia, NC, CCN 340032
  • Mercy Medical Center - Cedar Rapids Hospital, Cedar Rapids, IA, CCN 160079
  • St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002
  • Scotland Memorial Hospital Hospital, Laurinburg, NC, CCN 340008
  • Columbus Regional Healthcare System Hospital, Whiteville, NC, CCN 340068

Merit-based Incentive Payment System (MIPS)

Final score
96.22 of 100Reported as group
Quality
95.56
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2026013073MOMDDiagnostic Radiology Physician
31555TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
X-Ray Associates of New Mexico PC Diagnostic Radiology CurrentSince Jun 1, 2026 Accepting new patients
Scotland Memorial Hospital Inc CurrentSince Feb 1, 2026 Accepting new patients
Columbus Regional Healthcare System CurrentSince Dec 1, 2025 Accepting new patients
Columbus Regional Healthcare System CurrentSince Dec 1, 2025 Accepting new patients
Gaston Radiology PA Diagnostic Radiology CurrentSince Jul 15, 2005 Accepting new patients
Valley Radiology P a Diagnostic Radiology CurrentSince Dec 1, 2025 Accepting new patients
Scotland Memorial Hospital Inc Diagnostic Radiology CurrentSince Feb 1, 2026 Accepting new patients
Gaston Radiology Diagnostic Radiology Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

1220 Spruce St
Belmont, NC 28012
Phone (704) 825-5333

209 Park St
Ste 300
Belmont, NC 28012

1212 Spruce St
Belmont, NC 28012
Phone (704) 825-5677

600 W Trade St
Ste B
Dallas, NC 28034
Phone (980) 834-9170

3186 Village Dr
Ste 201
Fayetteville, NC 28304
Phone 9104865700104

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

336 Burtonwood Dr
Gastonia, NC 28054
Phone (704) 867-8021

620 Summit Crossing Pl
Ste 106
Gastonia, NC 28054
Phone (704) 864-4378

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

451 E Charlotte Ave
Mt Holly, NC 28120
Phone (980) 834-2266

159 E Dallas Rd
Stanley, NC 28164
Phone (704) 263-0300

500 Jefferson St
Whiteville, NC 28472
Phone (910) 642-1776

2669 Scenic Dr
Alamogordo, NM 88310
Phone (505) 439-6100

Organizations & group practices 43

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.

View all 43

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1124029244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3053 W STATE ST",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201720",
            "telephone_number": "423-968-1144",
            "fax_number": "423-968-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603810",
            "telephone_number": "423-968-1144",
            "fax_number": "423-968-3453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 5010",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587025010",
            "country_code": "US",
            "telephone_number": "701-418-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1045 W Stephenson St",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "IL",
            "postal_code": "610324864",
            "country_code": "US",
            "telephone_number": "815-599-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6000 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Hannibal",
            "state": "MO",
            "postal_code": "634016887",
            "country_code": "US",
            "telephone_number": "573-248-5300",
            "fax_number": "573-248-5302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CREASY",
        "first_name": "JOHN",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2026013073",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "81937",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "31555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PGA (RR MEDICARE)",
            "identifier": "300108603",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64008402",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3140729",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "R06903",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200008400",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3844447",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7205066",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.