Individual provider Active NPI

Eliza Creedon

  • Psychiatric/Mental Health Nurse Practitioner
  • Frisco, TX
National Provider Identifier
1407534522
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1002430 Issued in TX
Practice address
5300 Town and Country Blvd Ste 240
Frisco, TX 75034-1008
Phone
(972) 846-4080
Fax
(972) 947-5231
NPI assigned
Jul 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1002430 TX Primary

Addresses

Primary practice location

5300 Town and Country Blvd Ste 240
Frisco, TX 75034-1008

Mailing address

5300 Town and Country Blvd Ste 240
Frisco, TX 75034-1008
Phone (972) 846-4080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230814002728 TX Practitioner - Nurse Practitioner 6709248388 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shahla Ali MD PAGroup PAC ID 4587971452, 25 clinicians

Practice addresses (Care Compare)

1772 W McDermott Dr
Allen, TX 75013-3342
Phone (469) 340-2777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1002430TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shahla Ali MD PA CurrentSince Jul 28, 2023 Accepting new patients
Shahla Ali MD PA CurrentSince Jul 28, 2023 Accepting new patients
Creedon Psychiatry PLLC Psychiatric/Mental Health Current Accepting new patients

Locations

1774 W McDermott Dr
Ste 150
Allen, TX 75013
Phone (469) 340-2777

5300 Town and Country Blvd
Ste 240
Frisco, TX 75034
Phone (469) 833-3360

Organizations & group practices 3

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": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1407534522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 TOWN AND COUNTRY BLVD STE 240",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750341008",
            "telephone_number": "972-846-4080",
            "fax_number": "972-947-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 TOWN AND COUNTRY BLVD STE 240",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750341008",
            "telephone_number": "972-846-4080",
            "fax_number": "972-947-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEDON",
        "first_name": "ELIZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1002430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.