Individual provider Active NPI

Kiesha Richcreek, LC

  • Clinical Ethicist
  • Wyoming, MI
National Provider Identifier
1245619386
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical EthicistTaxonomy code 174V00000X
Practice address
2781 Woodlake Rd SW
Suite 6
Wyoming, MI 49519-4645
Phone
(616) 710-8678
Fax
(616) 608-3869
NPI assigned
May 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Ethicist 174V00000X Primary

Addresses

Primary practice location

2781 Woodlake Rd SW
Suite 6
Wyoming, MI 49519-4645

Mailing address

2781 Woodlake Rd SW
Suite 6
Wyoming, MI 49519-4645
Phone (616) 710-8678

Other names 1

  • Kiki Richcreek Professional name

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

NPI Registry JSON

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1245619386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2781 WOODLAKE RD SW",
            "address_2": "SUITE 6",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194645",
            "telephone_number": "616-710-8678",
            "fax_number": "616-608-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2781 WOODLAKE RD SW",
            "address_2": "SUITE 6",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194645",
            "telephone_number": "616-710-8678",
            "fax_number": "616-608-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHCREEK",
        "first_name": "KIESHA",
        "credential": "LC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-21",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174V00000X",
            "taxonomy_group": "",
            "desc": "Clinical Ethicist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIKI",
            "last_name": "RICHCREEK",
            "credential": "LC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.