Individual provider Active NPI

Kathryn Creagh

  • Adult Health Nurse Practitioner
  • Stamford, CT
National Provider Identifier
1588088355
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5727 Issued in CT
Practice address
29 Hospital Plaza
Suite 502
Stamford, CT 06902-3602
Phone
(203) 348-7410
Fax
(203) 961-8488
NPI assigned
Feb 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5727 CT Primary

Addresses

Primary practice location

29 Hospital Plaza
Suite 502
Stamford, CT 06902-3602

Mailing address

215 Stillwater Ave Ste B
Stamford, CT 06902-9504
Phone (203) 348-7410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20140627000123 CT Practitioner - Nurse Practitioner 0648495069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart Center PLLCGroup PAC ID 9830450162, 3 clinicians

Practice addresses (Care Compare)

215 Stillwater Ave
Suite B
Stamford, CT 06902-9504
Phone (203) 674-1810

Hospital & facility affiliations

  • Stamford Hospital Hospital, Stamford, CT, CCN 070006
  • Greenwich Hospital Association - Hospital, Greenwich, CT, CCN 070018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Center PLLC CurrentSince Jul 30, 2018 Accepting new patients
Silver Summit Medical Corporation PastSince Jul 30, 2018 Accepting new patients

Locations

215 Stillwater Ave
Ste B
Stamford, CT 06902
Phone (203) 674-1810

Interoperability endpoints

  • Direct secure messaging: theheartcenter.kathryncreagh@139468.advancedmd-direct.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 2

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": "1392249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1588088355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 STILLWATER AVE STE B",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069029504",
            "telephone_number": "203-348-7410",
            "fax_number": "203-961-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 HOSPITAL PLAZA",
            "address_2": "SUITE 502",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023602",
            "telephone_number": "203-348-7410",
            "fax_number": "203-961-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREAGH",
        "first_name": "KATHRYN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-13",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "5727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.