Individual provider Active NPI

Jeanne Creekmore, PH.D.

  • Psychologist
  • Washington, DC
National Provider Identifier
1497957310
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1000153 Issued in DC
Practice address
50 E St SE
Washington, DC 20003-2620
Phone
(703) 463-8820
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1000153 DC Primary

Addresses

Primary practice location

50 E St SE
Washington, DC 20003-2620

Mailing address

50 E St SE
Washington, DC 20003-2620
Phone (703) 463-8820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100107000497 DC Practitioner - Clinical Psychologist 5698816007 Practice locations: Washington, DC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

50 E Sest
Washington, DC 20003-2620
Phone (703) 463-8820

50 E St SE
Suite 300
Washington, CT 20003-2620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1000153DCMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1497957310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 E ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200032620",
            "telephone_number": "703-463-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200032620",
            "telephone_number": "703-463-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEKMORE",
        "first_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DC",
            "license": "1000153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.