Individual provider Active NPI

Katie Ann Creager, CPNP

  • Pediatric Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1629352760
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
12559 Issued in OH
Practice address
9500 Euclid Avenue
Suite A120
Cleveland, OH 44195
Phone
(216) 444-3753
NPI assigned
Oct 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 12559 OH Primary

Addresses

Primary practice location

9500 Euclid Avenue
Suite A120
Cleveland, OH 44195

Mailing address

9500 Euclid Avenue
Suite A120
Cleveland, OH 44195
Phone (216) 444-3753

Other names 1

  • Miss Katie Ann Spice Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120420000392 OH Practitioner - Nurse Practitioner 9335300136 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12559OHMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Mar 13, 2012 Accepting new patients

Locations

36901 American Way
Avon, OH 44011
Phone (440) 930-6200

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

9500 Euclid Ave
Ste A120
Cleveland, OH 44195
Phone (216) 444-3753

850 Columbia Rd
Ste 105
Westlake, OH 44145
Phone (440) 250-5737

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1629352760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVENUE",
            "address_2": "SUITE A120",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44195",
            "telephone_number": "216-444-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVENUE",
            "address_2": "SUITE A120",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44195",
            "telephone_number": "216-444-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREAGER",
        "first_name": "KATIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-07",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "12559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "SPICE",
            "middle_name": "ANN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.