Active NPI
Jerry D McCreery, M.D.
- Family Medicine Physician
- West Liberty, OH
National Provider Identifier
1407859689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35051131M
- Practice address
- 4879 US Highway 68 S
West Liberty, OH 43357-9525 - Phone
- (937) 599-1411
- Fax
- (937) 599-4128
- NPI assigned
- May 23, 2005
- Last updated
- Aug 8, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35051131M | OH | Primary |
Addresses
Primary practice location
4879 US Highway 68 S
West Liberty, OH 43357-9525
Mailing address
4879 US Highway 68 S
West Liberty, OH 43357-9525
Phone (937) 599-1411
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0582589 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35051131M | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Fairfield Healthcare Professionals, Inc. | Past | Accepting new patients | |
| Mary Rutan Hospital | Family Medicine | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Fairfield Medical Urgent Care
- Urgent Care Clinic/Center
- Lancaster, OH
- NPI 1700334182
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
dba Mad River Family Practice
- Family Medicine Physician
- West Liberty, OH
- NPI 1003875949
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407456000000",
"number": "1407859689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4879 US HIGHWAY 68 S",
"city": "WEST LIBERTY",
"state": "OH",
"postal_code": "433579525",
"telephone_number": "937-599-1411",
"fax_number": "937-599-4128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4879 US HIGHWAY 68 S",
"city": "WEST LIBERTY",
"state": "OH",
"postal_code": "433579525",
"telephone_number": "937-599-1411",
"fax_number": "937-599-4128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCREERY",
"first_name": "JERRY",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-23",
"last_updated": "2014-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35051131M",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0582589",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Liberty, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.