Individual provider Active NPI

Susan E Creamer, PAC

  • Medical Physician Assistant
  • Owings Mills, MD
National Provider Identifier
1720252257
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0001526 Issued in MD
Practice address
10 Crossroads Dr
Suite 100
Owings Mills, MD 21117-5458
Phone
(410) 363-7172
Fax
(410) 363-7188
NPI assigned
Apr 16, 2008
Last updated
Apr 16, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0001526 MD Primary

Addresses

Primary practice location

10 Crossroads Dr
Suite 100
Owings Mills, MD 21117-5458

Mailing address

10 Crossroads Dr
Suite 100
Owings Mills, MD 21117-5458
Phone (410) 363-7172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160414001003 MD Order and Referring Only - Physician Assistant 4082912647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C0001526MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

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": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1720252257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CROSSROADS DR",
            "address_2": "SUITE 100",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175458",
            "telephone_number": "410-363-7172",
            "fax_number": "410-363-7188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CROSSROADS DR",
            "address_2": "SUITE 100",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175458",
            "telephone_number": "410-363-7172",
            "fax_number": "410-363-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREAMER",
        "first_name": "SUSAN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0001526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.