Individual provider Active NPI

Freddy Morris Creekmore, PA-C

  • Physician Assistant
  • Wilkesboro, NC
National Provider Identifier
1255678280
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08618 Issued in NC
Practice address
1600 River St
Wilkesboro, NC 28697-7630
Phone
(336) 646-7272
NPI assigned
Jan 10, 2013
Last updated
Apr 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110006193 VA
Physician Assistant 363A00000X 0010-08618 NC Primary
Pharmacotherapy Pharmacist 1835P1200X 9987 KY
Pharmacotherapy Pharmacist 1835P1200X 31759 TN
Pharmacotherapy Pharmacist 1835P1200X 1523731701 UT

Addresses

Primary practice location

1600 River St
Wilkesboro, NC 28697-7630

Mailing address

1600 River St
Wilkesboro, NC 28697-7630
Phone (336) 646-7272

Other practice location 1

807 University Pkwy
Johnson City, TN 37614
Phone (423) 439-2083

Other practice location 2

103 Medical Heights Dr
Morganton, NC 28655
Phone (828) 437-4211

Other practice location 3

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC, TN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180725002966 VA Practitioner - Physician Assistant 2769739473 Reassigns benefits to 1 organization
I20190131001589 NC Practitioner - Physician Assistant 2769739473 Reassigns benefits to 4 organizations
I20221130002448 TN Practitioner - Physician Assistant 2769739473 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Practice addresses (Care Compare)

262 Leroy George Dr
Clyde, NC 28721-7430
Phone (828) 456-7311

509 Biltmore Ave
Asheville, NC 28801-4601
Phone (828) 213-1111

615 Ridge Rd
Roxboro, NC 27573-4629
Phone (336) 599-2121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.39 of 100Reported as apm
Quality
77.7
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9987KYMDPharmacotherapy Pharmacist
31759TNMDPharmacotherapy Pharmacist
1523731701UTMDPharmacotherapy Pharmacist
0010-08618NCMDPhysician Assistant
0110006193VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Community Anesthesiology Specialists LLC CurrentSince Nov 4, 2023 Accepting new patients
Mission Community Anesthesiology Specialists LLC CurrentSince Nov 4, 2023 Accepting new patients
Emergency Coverage Services, PC Physician Assistant Past Accepting new patients
Theoria Medical Physician Assistant Past Accepting new patients

Locations

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

70 Sweeten Creek Rd
Asheville, NC 28803
Phone (828) 274-7645

800 Medical Campus Dr
Burnsville, NC 28714
Phone (828) 682-0200

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

189 Hospital Dr
Spruce Pine, NC 28777
Phone (828) 682-0200

Organizations & group practices 11

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1255678280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 RIVER ST",
            "city": "WILKESBORO",
            "state": "NC",
            "postal_code": "286977630",
            "telephone_number": "336-646-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 RIVER ST",
            "city": "WILKESBORO",
            "state": "NC",
            "postal_code": "286977630",
            "telephone_number": "336-646-7272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "807 University Pkwy",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "37614",
            "country_code": "US",
            "telephone_number": "423-439-2083",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "103 Medical Heights Dr",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "28655",
            "country_code": "US",
            "telephone_number": "828-437-4211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271570001",
            "country_code": "US",
            "telephone_number": "336-716-2255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CREEKMORE",
        "first_name": "FREDDY",
        "middle_name": "MORRIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-10",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006193",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08618",
            "primary": true
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "KY",
            "license": "9987",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "TN",
            "license": "31759",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "UT",
            "license": "1523731701",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkesboro, NC

Sources for this page

Verify at the official NPI Registry.