Organization Active NPI

Richard D. Creed O.D. PC

  • Optometrist
  • Muskogee, OK
National Provider Identifier
1700075751
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1148 Issued in OK
Legal business name
RICHARD D. CREED O.D. PC
Practice address
3705 W Broadway St
Muskogee, OK 74401-2142
Phone
(918) 687-7530
Fax
(918) 687-4019
NPI assigned
Oct 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Authorized official

Name
Dr. Richard D Creed, O.D.NPI 1144325655
Title
President Ceo
Phone
(918) 687-7530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1148 OK Primary

Addresses

Primary practice location

3705 W Broadway St
Muskogee, OK 74401-2142

Mailing address

3705 W Broadway St
Muskogee, OK 74401-2142
Phone (918) 687-7530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100720000761 OK Part B Supplier - Clinic/Group Practice 4082746433 Receives reassigned benefits from 2 practitioners
Practice locations: Muskogee, OK

National Provider Directory

National Provider Directory

Locations

3705 W Broadway St
Muskogee, OK 74401
Phone (918) 687-7530

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1700075751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 W BROADWAY ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744012142",
            "telephone_number": "918-687-7530",
            "fax_number": "918-687-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 W BROADWAY ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744012142",
            "telephone_number": "918-687-7530",
            "fax_number": "918-687-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD D. CREED O.D. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "CREED",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "918-687-7530",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.