Individual provider Active NPI

Joseph Andrew Creedon, PSY.D.

  • Psychologist
  • Columbus, OH
National Provider Identifier
1275076895
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
7521 Issued in OH
Practice address
2 Easton Oval
Suite 450
Columbus, OH 43219-6036
Phone
(614) 475-9500
Fax
(614) 475-9821
NPI assigned
Nov 30, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 7521 OH Primary

Addresses

Primary practice location

2 Easton Oval
Suite 450
Columbus, OH 43219-6036

Mailing address

2 Easton Oval
Suite 450
Columbus, OH 43219-6036
Phone (614) 475-9500

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

State licenses

LicenseStateTypeSpecialty
7521OHMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Integrated Psychological Services Psychologist PastSince Oct 24, 2013 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1275076895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 EASTON OVAL",
            "address_2": "SUITE 450",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196036",
            "telephone_number": "614-475-9500",
            "fax_number": "614-475-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EASTON OVAL",
            "address_2": "SUITE 450",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196036",
            "telephone_number": "614-475-9500",
            "fax_number": "614-475-9821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEDON",
        "first_name": "JOSEPH",
        "middle_name": "ANDREW",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-30",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "7521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.