Creekside Family Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CREEKSIDE FAMILY CARE LLC

Practice address

1345 W Mason St Ste 202
Green Bay, WI 54303-2049

Phone

(920) 301-3907

Fax

(920) 391-5180

NPI assigned

Nov 3, 2021

Organization subpart

No

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

Authorized official

Name

Daquet ReedNPI 1871112003

Title

Owner/Administrator

Phone

(920) 301-3907

Specialties & licenses 1

Addresses

Listed as

Creekside Family Care, LLCCCN 527345

Ownership

-

Certified

Apr 11, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 1

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

• Daquet Reed

  • Home Health Agency
  • Green Bay, WI
  • NPI 1871112003
  NPD Authorized official

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1700541984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 W MASON ST STE 202",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032049",
            "telephone_number": "920-301-3907",
            "fax_number": "920-391-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 W MASON ST STE 202",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032049",
            "telephone_number": "920-301-3907",
            "fax_number": "920-391-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "DAQUET",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "920-301-3907"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan M Coyle, COTA
• Hannah Sue Craanen, AGNP
• Candice Crabb
• Samantha Jo Craw
• Elizabeth Creapeau, LPC, CSAC
• Bogdan Cristescu, M.D.
• Ivona Roxana Cristi, DDS
• Kevin William Cropsey
• Jeremy D. Cross, M.S.P.T.
• Sarah Lynn Cross, APRN

• Home Health Agency in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Home Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.