Individual provider Active NPI

Cecil Arthur Creasy III, PHARMD

  • Pharmacist
  • Whiteville, NC
National Provider Identifier
1194485110
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
30750 Issued in NC
Practice address
902 N JK Powell Blvd
Whiteville, NC 28472-2115
Phone
(910) 642-0194
NPI assigned
Dec 20, 2021
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 30750 NC Primary

Addresses

Primary practice location

902 N JK Powell Blvd
Whiteville, NC 28472-2115

Mailing address

747 Wharton Ave
Wilmington, NC 28412-8294
Phone (910) 520-9566

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
30750NCMDGeriatric Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1194485110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 WHARTON AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284128294",
            "telephone_number": "910-520-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N JK POWELL BLVD",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284722115",
            "telephone_number": "910-642-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREASY",
        "first_name": "CECIL",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "30750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.