NPIMap

Organization Active NPI

Creative Health Care Management, LLC

  • Physical Therapist
  • Washington, DC
National Provider Identifier
1487239349
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CREATIVE HEALTH CARE MANAGEMENT, LLC
Practice address
4656 Livingston Rd SE
Washington, DC 20032-3136
Phone
(202) 519-0982
Fax
(317) 708-6496
NPI assigned
Mar 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Authorized official

Name
Misty D Beaudry-Zobel
Title
Reimbursement
Phone
(317) 204-3736

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

4656 Livingston Rd SE
Washington, DC 20032-3136

Mailing address

10 S 9TH St Ste 4
Noblesville, IN 46060-2631
Phone (765) 524-3946

Other names 1

  • Vertis Therapy - DC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210427000697 DC Part B Supplier - Clinic/Group Practice 4385929892 Receives reassigned benefits from 10 practitioners
Practice locations: Washington, DC

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Creative HLTH Care6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615507200000",
    "number": "1487239349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 S 9TH ST STE 4",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460602631",
            "telephone_number": "765-524-3946",
            "fax_number": "317-708-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4656 LIVINGSTON RD SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200323136",
            "telephone_number": "202-519-0982",
            "fax_number": "317-708-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE HEALTH CARE MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-03-12",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "BEAUDRY-ZOBEL",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "REIMBURSEMENT",
        "authorized_official_telephone_number": "317-204-3736"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vertis Therapy - DC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.