NPIMap

Organization Active NPI

Creative Medical Consulting, LLC

  • Family Nurse Practitioner
  • Middletown, DE
National Provider Identifier
1578051819
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0000781 Issued in DE
Legal business name
CREATIVE MEDICAL CONSULTING, LLC
Practice address
120 W Main St Ste 202
Middletown, DE 19709-1040
Phone
(302) 313-1411
Fax
(844) 312-6150
NPI assigned
Apr 23, 2018
Last updated
Apr 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Authorized official

Name
Stephanie A Evans-Mitchell, EDD, MSN, APRNNPI 1437547668
Title
Ceo
Phone
(302) 312-6150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LG-0000781 DE Primary

Addresses

Primary practice location

120 W Main St Ste 202
Middletown, DE 19709-1040

Mailing address

120 W Main St Ste 202
Middletown, DE 19709-1040
Phone (302) 313-1411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180605000164 DE Part B Supplier - Clinic/Group Practice 7719242205 Receives reassigned benefits from 12 practitioners
Practice locations: Chestertown, MD; Odessa, DE

National Provider Directory

National Provider Directory

Locations

120 W Main St
Ste 202
Middletown, DE 19709
Phone (302) 312-6150

952 Washington Ave
Chestertown, MD 21620
Phone (410) 778-0003

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524441600000",
    "number": "1578051819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST STE 202",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091040",
            "telephone_number": "302-313-1411",
            "fax_number": "844-312-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST STE 202",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091040",
            "telephone_number": "302-313-1411",
            "fax_number": "844-312-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE MEDICAL CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-04-23",
        "status": "A",
        "authorized_official_last_name": "EVANS-MITCHELL",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "302-312-6150",
        "authorized_official_credential": "EDD, MSN, APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0000781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.