Individual provider Active NPI

Jaycee Caraline Creecy, MCD, CF-SLP

  • Speech-Language Pathologist
  • Jonesboro, AR
National Provider Identifier
1437718061
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1699 Red Wolf Blvd Ste H
Jonesboro, AR 72401-5453
Phone
(870) 336-0021
NPI assigned
Jun 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 2355S0801X AR
Speech-Language Pathologist 235Z00000X AR Primary

Addresses

Primary practice location

1699 Red Wolf Blvd Ste H
Jonesboro, AR 72401-5453

Mailing address

1805 Executive SQ
Jonesboro, AR 72401-6086

Other identifiers 2

IdentifierTypeStateIssuer
934393304OtherARDRIVER'S LICENSES
14382031OtherARAMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION

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

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1437718061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 EXECUTIVE SQ",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 RED WOLF BLVD STE H",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015453",
            "telephone_number": "870-336-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREECY",
        "first_name": "JAYCEE",
        "middle_name": "CARALINE",
        "credential": "MCD, CF-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSES",
            "identifier": "934393304",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION",
            "identifier": "14382031",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.