Active NPI
Kristi Lynn Creahan
- Speech-Language Pathologist
- Hilton, NY
National Provider Identifier
1841500964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 020340-1
- Practice address
- 100 School LN
Hilton, NY 14468-1242 - Phone
- (585) 392-1000
- NPI assigned
- Oct 8, 2010
- Last updated
- Oct 24, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 020340-1 | NY | Primary |
Addresses
Primary practice location
100 School LN
Hilton, NY 14468-1242
Mailing address
55 Shadowmoor Dr
Fairport, NY 14450-2239
Phone (585) 506-7932
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03648271 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020340-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382572800000",
"number": "1841500964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 SHADOWMOOR DR",
"city": "FAIRPORT",
"state": "NY",
"postal_code": "144502239",
"telephone_number": "585-506-7932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SCHOOL LN",
"city": "HILTON",
"state": "NY",
"postal_code": "144681242",
"telephone_number": "585-392-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CREAHAN",
"first_name": "KRISTI",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-08",
"last_updated": "2013-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "020340-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03648271",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hilton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.