Individual provider Active NPI

Haley Long McCreery, O.D.

  • Optometrist
  • Rolla, MO
National Provider Identifier
1861807364
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2014020352 Issued in MO
Practice address
1211 Hauck Dr
Rolla, MO 65401-4900
Phone
(573) 364-6300
NPI assigned
Jun 24, 2014
Last updated
Jun 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2014020352 MO Primary

Addresses

Primary practice location

1211 Hauck Dr
Rolla, MO 65401-4900

Mailing address

237 Highway MM
Eldon, MO 65026-5110
Phone (573) 280-5649

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140805002117 MO Practitioner - Optometry 7517184120 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2014020352MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Medical Center, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Richland Medical Center, Inc CurrentSince Jan 1, 2026 Accepting new patients
V G Green PC Inc Optometrist PastSince Jul 1, 2014 Accepting new patients

Locations

304 W Washington Ave
Richland, MO 65556
Phone (573) 765-5131

Organizations & group practices 5

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": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1861807364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 HIGHWAY MM",
            "city": "ELDON",
            "state": "MO",
            "postal_code": "650265110",
            "telephone_number": "573-280-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 HAUCK DR",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654014900",
            "telephone_number": "573-364-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCREERY",
        "first_name": "HALEY",
        "middle_name": "LONG",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2014020352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

Verify at the official NPI Registry.