Active NPI
Courtney Creasey
- Physician Assistant
- Lockport, NY
National Provider Identifier
1558198366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 032582
- Practice address
- 5526 Niagara Street Ext
Lockport, NY 14094-1804 - Phone
- (716) 438-3393
- NPI assigned
- Sep 16, 2024
- Last updated
- Sep 16, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 032582 | NY | Primary |
Addresses
Primary practice location
5526 Niagara Street Ext
Lockport, NY 14094-1804
Mailing address
424 Somerville Ave
Tonawanda, NY 14150-8112
Phone (716) 480-6647
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 |
|---|---|---|---|
| 032582 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726444800000",
"number": "1558198366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 SOMERVILLE AVE",
"city": "TONAWANDA",
"state": "NY",
"postal_code": "141508112",
"telephone_number": "716-480-6647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5526 NIAGARA STREET EXT",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140941804",
"telephone_number": "716-438-3393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CREASEY",
"first_name": "COURTNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-16",
"last_updated": "2024-09-16",
"certification_date": "2024-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "032582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lockport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.