Active NPI
Anna McCredy
- Physician Assistant
- Fayetteville, AR
National Provider Identifier
1619721909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA-1515
- Practice address
- 1695 E Rainforest Rd
Fayetteville, AR 72703-5385 - Phone
- (479) 445-6460
- NPI assigned
- Apr 15, 2024
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-1515 | AR | Primary |
Addresses
Primary practice location
1695 E Rainforest Rd
Fayetteville, AR 72703-5385
Mailing address
PO Box 279
Goshen, AR 72735-0279
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787184000000",
"number": "1619721909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 279",
"city": "GOSHEN",
"state": "AR",
"postal_code": "727350279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1695 E RAINFOREST RD",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727035385",
"telephone_number": "479-445-6460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCREDY",
"first_name": "ANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-15",
"last_updated": "2026-08-20",
"certification_date": "2026-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AR",
"license": "PA-1515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.