Walter P. Creel, D.C., Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

513 Issued in LA

Legal business name

WALTER P. CREEL, D.C., INC.

Practice address

12051 Hwy 84 West
Jena, LA 71342

Phone

(318) 992-2022

Fax

(318) 992-2037

NPI assigned

Mar 27, 2008

Organization subpart

Yes

Parent organization

WALTER P. CREEL, D.C., INC.As reported in NPPES

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

Authorized official

Name

Walter P CreelNPI 1750305132

Title

Chiropractor

Phone

(318) 992-2022

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Part of

Walter P Creel DC Inc

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Walter P Creel, DC

  • Chiropractor
  • Jena, LA
  • NPI 1750305132
  Medicare reassignment NPD Authorized official
• Melissa Etage Manuel, DC

  • Chiropractor
  • Jena, LA
  • NPI 1205044229
  Medicare reassignment NPD

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1306018510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1333",
            "city": "JENA",
            "state": "LA",
            "postal_code": "713421333",
            "telephone_number": "318-992-2022",
            "fax_number": "318-992-2037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12051 HWY 84 WEST",
            "city": "JENA",
            "state": "LA",
            "postal_code": "71342",
            "telephone_number": "318-992-2022",
            "fax_number": "318-992-2037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER P. CREEL, D.C., INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALTER P. CREEL, D.C., INC.",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "CREEL",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "318-992-2022"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1955272",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Toni J Watson I, MS, CAC
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• Kendra Rhaelana Webster-Taylor, LMSW, LPN
• Samantha Weisskopf, MHS
• Taylor Williams, FNP-C

• Chiropractor in Jena, LA
• Providers in Jena, LA by specialty
• Chiropractor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.