Alice Barton Creque

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004464 Issued in KY

Practice address

141 Stonecrest Rd
Unit 2
Shelbyville, KY 40065-8166

Phone

(502) 647-0133

Fax

(502) 647-0138

NPI assigned

Dec 18, 2007

Last updated

Dec 18, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Max Performance Physical Therapy and Sports Rehab, LLC

  • Physical Therapist
  • Shelbyville, KY
  • NPI 1508928300
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1699959221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 STONECREST RD",
            "address_2": "UNIT 2",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658166",
            "telephone_number": "502-647-0133",
            "fax_number": "502-647-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 STONECREST RD",
            "address_2": "UNIT 2",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658166",
            "telephone_number": "502-647-0133",
            "fax_number": "502-647-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREQUE",
        "first_name": "ALICE",
        "middle_name": "BARTON",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "004464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Michelle Cravens, COTA/L
• Laura J Crawford, M.S.
• Nicole Marie Crawford, PHARMD
• CRC Health Treatment Clinics, LLC (Shelbyville Comprehensive Treatment Center)
• CRC Health Treatment Clinics, LLC 3255
• Ron E Creque Jr., MD
• Crestview Nursing, LLC (Crestview Center)
• Susan E Crumbaugh
• CSD Medical Services
• Cumberland Family Medical Center Inc (Womens Care of the Blugrass-Shelbyville)

• Physical Therapist in Shelbyville, KY
• Providers in Shelbyville, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.