NPIMap

Organization Active NPI

Creoks Mental Health Services

  • Community/Behavioral Health Agency
  • Shawnee, OK
National Provider Identifier
1730452459
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
561 Issued in OK
Legal business name
CREOKS MENTAL HEALTH SERVICES
Practice address
504 N Broadway Ave
Shawnee, OK 74801-6927
Phone
(405) 275-1844
Fax
(405) 275-1124
NPI assigned
Feb 10, 2012
Last updated
Aug 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Authorized official

Name
Kerri Watson
Title
Credentialing Director
Phone
(918) 698-1771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 561 OK Primary

Addresses

Primary practice location

504 N Broadway Ave
Shawnee, OK 74801-6927

Mailing address

323 W 6TH St
Okmulgee, OK 74447-5019
Phone (918) 756-9411

Other identifiers 1

IdentifierTypeStateIssuer
100734620MedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161101000781 OK Part B Supplier - Clinic/Group Practice 0749591469 Receives reassigned benefits from 76 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Stillwater, OK; Shawnee, OK; Sapulpa, OK; Sallisaw, OK; Poteau, OK; Pawnee, OK; Okmulgee, OK; Oklahoma City, OK…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Creoks Mental Health70 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

504 N Broadway Ave
Shawnee, OK 74801
Phone (405) 275-1844

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1730452459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 W 6TH ST",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744475019",
            "telephone_number": "918-756-9411",
            "fax_number": "918-756-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N BROADWAY AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748016927",
            "telephone_number": "405-275-1844",
            "fax_number": "405-275-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREOKS MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-10",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "KERRI",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "918-698-1771"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100734620",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; 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.