Creative Care Specialist PLLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP7465 Issued in AZ

Legal business name

CREATIVE CARE SPECIALIST PLLC

Practice address

4280 E Sierra Madre Ave
Gilbert, AZ 85296-1589

Phone

(480) 246-9242

NPI assigned

Dec 12, 2017

Organization subpart

No

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

Authorized official

Name

Eddie Belleza Tabarangao, NP

Title

Owner/Manager

Phone

(480) 246-9242

Specialties & licenses 4

Addresses

Other names 1

• CREATIVE CARE SPECIALIST PLLC Doing business as

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513036800000",
    "number": "1235644295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4280 E SIERRA MADRE AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 E SIERRA MADRE AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961589",
            "telephone_number": "480-246-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE CARE SPECIALIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-12",
        "last_updated": "2017-12-12",
        "status": "A",
        "authorized_official_last_name": "TABARANGAO",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "BELLEZA",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "480-246-9242",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AZ",
            "license": "AP7465",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AZ",
            "license": "AP7465",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "AZ",
            "license": "AP7465",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP7465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CREATIVE CARE SPECIALIST PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nurse Practitioner in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; 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.