Individual provider Active NPI

Stacy Creel

  • Acute Care Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1679956056
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN221254 Issued in GA
Practice address
6602 Waters Ave BLDG C
Savannah, GA 31406-2778
Phone
(912) 354-7676
Fax
(912) 354-6040
NPI assigned
Jul 3, 2015
Last updated
Mar 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN221254 GA Primary

Addresses

Primary practice location

6602 Waters Ave BLDG C
Savannah, GA 31406-2778

Mailing address

6602 Waters Ave BLDG C
Savannah, GA 31406-2778
Phone (912) 354-7676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20151028000732 GA Practitioner - Nurse Practitioner 0244549525 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN221254GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Savannah Neurology Specialists P C CurrentSince Mar 16, 2019 Accepting new patients

Locations

6602 Waters Ave
Bldg C
Savannah, GA 31406
Phone (912) 354-7676

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1679956056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6602 WATERS AVE BLDG C",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062778",
            "telephone_number": "912-354-7676",
            "fax_number": "912-354-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6602 WATERS AVE BLDG C",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062778",
            "telephone_number": "912-354-7676",
            "fax_number": "912-354-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEL",
        "first_name": "STACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-03",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN221254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.