Individual provider Active NPI

Judy Creech, RN/FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Abilene, TX
National Provider Identifier
1790978211
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP112205 Issued in TX
Practice address
2626 S Clack St
Abilene, TX 79606-1557
Phone
(325) 690-5100
Fax
(325) 690-5228
NPI assigned
Aug 20, 2007
Last updated
Jul 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP112205 TX Primary

Addresses

Primary practice location

2626 S Clack St
Abilene, TX 79606-1557

Mailing address

2616 S Clack St
Abilene, TX 79606-1557
Phone (325) 690-5131

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071127000267 TX Practitioner - Nurse Practitioner 8123116209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Abilene Regional MHMR CenterGroup PAC ID 9537117197, 12 clinicians

Practice addresses (Care Compare)

2616 S Clack St
Abilene, TX 79606-1557

2626 S Clack St
Abilene, TX 79606-1557
Phone (325) 690-5100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP112205TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Abilene Regional MHMR Center CurrentSince Jul 1, 2007 Accepting new patients
Jamison Professional Counseling Center Inc Past Accepting new patients
Privia Medical Group West Texas, PLLC Past Accepting new patients

Locations

2616 S Clack St
Abilene, TX 79606
Phone (325) 690-5100

2626 S Clack St
Abilene, TX 79606
Phone (325) 690-5100

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1790978211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 S CLACK ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061557",
            "telephone_number": "325-690-5131",
            "fax_number": "325-690-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 S CLACK ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061557",
            "telephone_number": "325-690-5100",
            "fax_number": "325-690-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREECH",
        "first_name": "JUDY",
        "credential": "RN/FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP112205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.