Active NPI
Stephanie Creager, PTA
- Physical Therapy Assistant
- Alamogordo, NM
National Provider Identifier
1497297600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA1491
- Practice address
- 2669 Scenic Dr
Alamogordo, NM 88310-8734 - Phone
- (575) 439-6100
- NPI assigned
- Nov 7, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA011188 | OH | |
| Physical Therapy Assistant | 225200000X | 2129133 | TX | |
| Physical Therapy Assistant | 225200000X | PTA1491 | NM | Primary |
Addresses
Primary practice location
2669 Scenic Dr
Alamogordo, NM 88310-8734
Mailing address
305 Cover PL
Columbus, OH 43235-6453
Phone (937) 681-0677
Other practice location 1
2469 Stelzer Rd
Columbus, OH 43219-3129
Phone (614) 416-6200
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 |
|---|---|---|---|
| PTA1491 | NM | MD | Physical Therapy Assistant |
| PTA011188 | OH | MD | Physical Therapy Assistant |
| 2129133 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556496000000",
"number": "1497297600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 COVER PL",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432356453",
"telephone_number": "937-681-0677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2669 SCENIC DR",
"city": "ALAMOGORDO",
"state": "NM",
"postal_code": "883108734",
"telephone_number": "575-439-6100"
}
],
"practiceLocations": [
{
"address_1": "2469 Stelzer Rd",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432193129",
"country_code": "US",
"telephone_number": "614-416-6200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CREAGER",
"first_name": "STEPHANIE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-07",
"last_updated": "2019-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "PTA011188",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2129133",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NM",
"license": "PTA1491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Alamogordo, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.