Active NPI
Justin Eugene Creasey, ATC
- Athletic Trainer
- Knoxville, TN
National Provider Identifier
1164559977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT 0000000724
- Practice address
- 260 Fort Sanders West Blvd Ste 200
Knoxville, TN 37922-3355 - Phone
- (865) 558-4418
- NPI assigned
- Feb 28, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT 0000000724 | TN | Primary |
Addresses
Primary practice location
260 Fort Sanders West Blvd Ste 200
Knoxville, TN 37922-3355
Mailing address
2763 Sheringham Dr
Powell, TN 37849-4836
Phone (865) 947-5848
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT 0000000724 | TN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164559977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2763 SHERINGHAM DR",
"city": "POWELL",
"state": "TN",
"postal_code": "378494836",
"telephone_number": "865-947-5848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 FORT SANDERS WEST BLVD STE 200",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379223355",
"telephone_number": "865-558-4418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CREASEY",
"first_name": "JUSTIN",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "AT 0000000724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.