Active NPI
Karissa Joy Creswell, LMT
- Specialist
- Albuquerque, NM
National Provider Identifier
1619357142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 5241
- Practice address
- 5910 Cubero Dr NE
Suite C
Albuquerque, NM 87109-3842 - Phone
- (505) 999-7144
- NPI assigned
- May 29, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 5241 | NM | Primary |
Addresses
Primary practice location
5910 Cubero Dr NE
Suite C
Albuquerque, NM 87109-3842
Mailing address
5910 Cubero Dr NE
Suite C
Albuquerque, NM 87109-3842
Phone (505) 999-7144
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5241 | Other | NM | NM MASSAGE THERAPY BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5241 | NM | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432857600000",
"number": "1619357142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5910 CUBERO DR NE",
"address_2": "SUITE C",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871093842",
"telephone_number": "505-999-7144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5910 CUBERO DR NE",
"address_2": "SUITE C",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871093842",
"telephone_number": "505-999-7144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRESWELL",
"first_name": "KARISSA",
"middle_name": "JOY",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-29",
"last_updated": "2015-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NM",
"license": "5241",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NM MASSAGE THERAPY BOARD",
"identifier": "5241",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.