Ashley Nicole Creedy

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP60704623 Issued in WA

Practice address

2100 N Winrock St
Liberty Lake, WA 99019-5093

Phone

(208) 697-1421

NPI assigned

Jul 9, 2016

Last updated

Dec 6, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ashley Nicole Kopelson Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Spokane Emergency Physicians, PS

  • Emergency Medicine Physician
  • Spokane, WA
  • NPI 1235147117
  Medicare reassignment

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

{
    "created_epoch": "1468022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1619329034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N WINROCK ST",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990195093",
            "telephone_number": "208-697-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N WINROCK ST",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990195093",
            "telephone_number": "208-697-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEDY",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-09",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60704623",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "RN60311256",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "KOPELSON",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael P Condon, DDS
• Heidi Jo Cooper, PNP
• Brittany Claire Correll, D.C.
• Candace Courtney, LMT
• Abby Mae Covillo, PA-C
• Angela Marie Crigger, RN
• Shenette Gamoyao Cross
• Clifford Reed Cullings, DDS
• Phillip Wayne Curtis, MD
• Jeannie Dalton, LCSW

• Family Nurse Practitioner in Liberty Lake, WA
• Providers in Liberty Lake, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.