NPIMap

Organization Active NPI

Creative Journey, LLC

  • Case Manager/Care Coordinator
  • Jamestown, ND
National Provider Identifier
1740871201
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
CREATIVE JOURNEY, LLC
Doing business as
Creative Journey, LLC
Practice address
419 5TH St NE Ste 142
Jamestown, ND 58401-3318
Phone
(701) 658-9032
NPI assigned
Jan 28, 2021
Last updated
Jan 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Authorized official

Name
Shaulee A Iverson, MS OTR/LNPI 1184013377
Title
Owner/President
Phone
(701) 658-9032

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

419 5TH St NE Ste 142
Jamestown, ND 58401-3318

Mailing address

419 5TH St NE Ste 142
Jamestown, ND 58401-3318
Phone (701) 658-9032

Other names 1

  • Creative Journey, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Creative Journey LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1611792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1740871201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 5TH ST NE STE 142",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013318",
            "telephone_number": "701-658-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 5TH ST NE STE 142",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013318",
            "telephone_number": "701-658-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE JOURNEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "IVERSON",
        "authorized_official_first_name": "SHAULEE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "701-658-9032",
        "authorized_official_credential": "MS OTR/L"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creative Journey, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamestown, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.