NPIMap

Individual provider Active NPI

Laikyn Creque, PA-C

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1306562434
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3164 Issued in KY
Practice address
3906 S Dupont SQ Ste C
Louisville, KY 40207-4647
Phone
(812) 282-3899
Fax
(812) 282-4172
NPI assigned
Oct 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10004278A IN
Physician Assistant 363A00000X PA3164 KY Primary

Addresses

Primary practice location

3906 S Dupont SQ Ste C
Louisville, KY 40207-4647

Mailing address

101 Hospital Blvd
Jeffersonville, IN 47130-3769
Phone (812) 282-3899

Other names 1

  • Laikyn Locklear Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230927002890 KY Practitioner - Physician Assistant 9830543610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 E Liberty St
Suite 700
Louisville, KY 40202-1439
Phone (502) 583-5836

Hospital & facility affiliations

  • Baptist Health Louisville Hospital, Louisville, KY, CCN 180130
  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088
  • Baptist Health Hardin Hospital, Elizabethtown, KY, CCN 180012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA3164KYMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: laikyn.creque.p1@direct.kentuckianarheum.nextgenshare.com

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1306562434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL BLVD",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303769",
            "telephone_number": "812-282-3899",
            "fax_number": "812-282-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3906 S DUPONT SQ STE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074647",
            "telephone_number": "812-282-3899",
            "fax_number": "812-282-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREQUE",
        "first_name": "LAIKYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004278A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA3164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAIKYN",
            "last_name": "LOCKLEAR",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.