NPIMap

Individual provider Active NPI

Ronande Berryl Creebsburg, NP-C

  • Family Nurse Practitioner
  • Seneca, SC
National Provider Identifier
1225543242
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21130 Issued in SC
Practice address
1510 Blue Ridge Blvd Ste 105
Seneca, SC 29672-6684
Phone
(864) 722-5315
Fax
(864) 568-3894
NPI assigned
Dec 13, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21130 SC Primary

Addresses

Primary practice location

1510 Blue Ridge Blvd Ste 105
Seneca, SC 29672-6684

Mailing address

1510 Blue Ridge Blvd Ste 105
Seneca, SC 29672-6684
Phone (864) 722-5315

Other practice location 1

1510 Blue Ridge Blvd
Seneca, SC 29672-6683
Phone (864) 722-5315

Other identifiers 1

IdentifierTypeStateIssuer
GP7395MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200114002197 SC Practitioner - Nurse Practitioner 0244665511 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Community Health CareGroup PAC ID 8628227667, shared by 3 NPIs, 10 clinicians

Practice addresses (Care Compare)

302 Pearman Dairy Rd
Suite C1
Anderson, SC 29625-3802
Phone (864) 224-0822

403 Hillcrest Dr
Suite E
Easley, SC 29640-1207
Phone (864) 722-0283

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Community Health Care, Inc CurrentSince Oct 12, 2021 Accepting new patients
Foothills Community Health Care, Inc. CurrentSince Oct 20, 2019 Accepting new patients
Foothills Community Health Care, Inc CurrentSince Oct 20, 2019 Accepting new patients
Foothills Community Health Care, Inc. CurrentSince Oct 20, 2019 Accepting new patients
SC-Premier Wellness Care PastSince Apr 15, 2016 Accepting new patients
Foothills Community Health Care, Inc. Past Accepting new patients
Mountain Laurel Internal Medicine Past Accepting new patients

Locations

302 Pearman Dairy Rd
Ste C1
Anderson, SC 29625
Phone (864) 633-5171

110 Liberty Dr
Clemson, SC 29631
Phone (864) 722-0283

403 Hillcrest Dr
Easley, SC 29640
Phone (864) 343-1220

403 Hillcrest Dr
Ste E
Easley, SC 29640
Phone (864) 343-1220

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/fhir/r4
  • Direct secure messaging: ronande.creebsburg.1@30137.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1225543242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 BLUE RIDGE BLVD STE 105",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296726684",
            "telephone_number": "864-722-5315",
            "fax_number": "864-568-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 BLUE RIDGE BLVD STE 105",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296726684",
            "telephone_number": "864-722-5315",
            "fax_number": "864-568-3894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 Blue Ridge Blvd",
            "address_purpose": "LOCATION",
            "city": "Seneca",
            "state": "SC",
            "postal_code": "296726683",
            "country_code": "US",
            "telephone_number": "864-722-5315",
            "fax_number": "864-568-3894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CREEBSBURG",
        "first_name": "RONANDE",
        "middle_name": "BERRYL",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "21130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP7395",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.