Individual provider Active NPI

Stephanie Creager, PTA

  • Physical Therapy Assistant
  • Alamogordo, NM
National Provider Identifier
1497297600
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA1491 Issued in NM
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

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PTA1491NMMDPhysical Therapy Assistant
PTA011188OHMDPhysical Therapy Assistant
2129133TXMDPhysical 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.

Verify at the official NPI Registry.