Active NPI
Johnny Kenneth Creel
- Pharmacist
- Albany, GA
National Provider Identifier
1417049461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH023491
- Practice address
- 2800 Old Dawson Rd
Albany, GA 31707-1599 - Phone
- (229) 888-3530
- NPI assigned
- Sep 28, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9370 | AL | |
| Pharmacist | 183500000X | RPH023491 | GA | Primary |
Addresses
Primary practice location
2800 Old Dawson Rd
Albany, GA 31707-1599
Mailing address
175 Quail Valley Dr.
Leesburg, GA 31763
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9370 | AL | MD | Pharmacist |
| RPH023491 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417049461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 QUAIL VALLEY DR.",
"city": "LEESBURG",
"state": "GA",
"postal_code": "31763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 OLD DAWSON RD",
"city": "ALBANY",
"state": "GA",
"postal_code": "317071599",
"telephone_number": "229-888-3530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CREEL",
"first_name": "JOHNNY",
"middle_name": "KENNETH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "9370",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH023491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.