NPIMap

Individual provider Active NPI

Dustin A Creech, MD

  • Family Medicine Physician
  • Morrilton, AR
National Provider Identifier
1578884540
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-7331 Issued in AR
Practice address
10 Hospital Dr
Morrilton, AR 72110-4510
Phone
(501) 354-0052
NPI assigned
Jun 14, 2010
Last updated
Feb 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-7331 AR Primary

Addresses

Primary practice location

10 Hospital Dr
Morrilton, AR 72110-4510

Mailing address

180 S 3Rd St
Belleville, IL 62220-1952

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170227000510 AR Practitioner - Family Practice 6406093228 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morrilton Medical Clinic, P.a.Group PAC ID 2860482130, 8 clinicians
St Anthonys Hospital AssociationGroup PAC ID 4082516554, 10 clinicians

Practice addresses (Care Compare)

10 Hospital Dr
Morrilton, AR 72110-4510
Phone (501) 354-0052

4 Hospital Dr
Morrilton, AR 72110-4510
Phone (501) 977-2300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-7331ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morrilton Medical Clinic, P.a. CurrentSince Mar 13, 2017 Accepting new patients
Morrilton Medical Clinic, P.a. Family Medicine Past Accepting new patients

Locations

10 Hospital Dr
Morrilton, AR 72110
Phone (501) 354-0052

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Morrilton Medical Clinic, P.a.Morrilton, AR, CCN 043878 Rural health clinic 5% Or Greater Direct Ownership Interest (16.66%)
Corporate Officer (16.66%)		 Sep 1, 2018
Sep 1, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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

Hospital & facility affiliations 10

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": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1578884540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 S 3RD ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HOSPITAL DR",
            "city": "MORRILTON",
            "state": "AR",
            "postal_code": "721104510",
            "telephone_number": "501-354-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREECH",
        "first_name": "DUSTIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-14",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-7331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrilton, AR

Sources for this page

Verify at the official NPI Registry.