Individual provider Active NPI

Jordan House Creasy, FNP-C

  • Nurse Practitioner
  • Greensboro, NC
National Provider Identifier
1568341774
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5022966 Issued in NC
Practice address
4517 Jessup Grove Rd
Greensboro, NC 27410-9407
Phone
(336) 702-5635
NPI assigned
Sep 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5022966 NC
Nurse Practitioner 363L00000X 5022966 NC Primary

Addresses

Primary practice location

4517 Jessup Grove Rd
Greensboro, NC 27410-9407

Mailing address

1 Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-8132

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260330002075 NC Practitioner - Nurse Practitioner 3678058427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Kimel Forest Dr
Winston Salem, NC 27103-6074

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5022966NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PPPT, LLC CurrentSince Sep 8, 2025 Accepting new patients
Wake Forest University Health Sciences PastSince Sep 8, 2025 Accepting new patients

Locations

4517 Jessup Grove Rd
Greensboro, NC 27410
Phone (336) 314-0611

4517 Jessup Grove Rd
Fl 2
Greensboro, NC 27410
Phone (336) 702-5635

Interoperability endpoints

  • Direct secure messaging: jcreasy2993349@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1756684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1568341774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-8132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4517 JESSUP GROVE RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109407",
            "telephone_number": "336-702-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREASY",
        "first_name": "JORDAN",
        "middle_name": "HOUSE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-01",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5022966",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5022966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.