Active NPI
Joseph J Creely Jr., MD
- Otolaryngology Physician
- Metairie, LA
National Provider Identifier
1922044171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 10293
- Practice address
- 3645 Houma Blvd
Metairie, LA 70006 - Phone
- (504) 885-4677
- Fax
- (504) 888-0549
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 10293 | LA | Primary |
Addresses
Primary practice location
3645 Houma Blvd
Metairie, LA 70006
Mailing address
3645 Houma Blvd
Metairie, LA 70006
Phone (504) 885-4677
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1102938 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10293 | LA | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MG Desalvo MD&GM Gremillion Mdamc | Otolaryngology | Current | Accepting new patients |
Locations
3645 Houma Blvd
Metairie, LA 70006
Phone (504) 885-4677
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213228800000",
"number": "1922044171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3645 HOUMA BLVD",
"city": "METAIRIE",
"state": "LA",
"postal_code": "70006",
"telephone_number": "504-885-4677",
"fax_number": "504-888-0549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3645 HOUMA BLVD",
"city": "METAIRIE",
"state": "LA",
"postal_code": "70006",
"telephone_number": "504-885-4677",
"fax_number": "504-888-0549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CREELY",
"first_name": "JOSEPH",
"middle_name": "J",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2008-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "LA",
"license": "10293",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1102938",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Metairie, LA
- Creel Hearing Center, L.L.C.
- Creel Hearing Center, LLC
- Jeffery Lance Creel II, AUD.
- Terry Creel, M.D
- Brian Christopher Creely, M.D.
- Gregory D Crenshaw, MD
- Crescent City Anesthesia Services, LLC
- Crescent City Counseling Center & Associates, LLC
- Crescent City Doula LLC
- Crescent City Hearing Center, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.