Individual provider Active NPI

Jonathan Dale Edward Creech, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Fayetteville, AR
National Provider Identifier
1922495779
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
E-14444 Issued in AR
Practice address
3317 N Wimberly Dr
Fayetteville, AR 72703-4056
Phone
(479) 521-2752
Fax
(479) 521-4603
NPI assigned
Apr 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X E-14444 AR Primary

Addresses

Primary practice location

3317 N Wimberly Dr
Fayetteville, AR 72703-4056

Mailing address

3317 N Wimberly Dr
Fayetteville, AR 72703-4056
Phone (479) 521-2752

Other practice location 1

603-2 N Progress Ave Ste 600
Siloam Springs, AR 72761-4610
Phone (479) 521-2752

Other practice location 2

1800 SE Moberly Ln
Bentonville, AR 72712-7017
Phone (479) 521-2752

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jonathan.creech.1@18403.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210723002509 AR Practitioner - Orthopedic Surgery 8123444395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Loma Linda University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fands Physical Therapy, IncGroup PAC ID 7810898459, 217 clinicians
Ozark Physical Therapy Inc.Group PAC ID 1052400850, 44 clinicians
Ozark Orthopaedics, P.a.Group PAC ID 2860477189, 57 clinicians

Practice addresses (Care Compare)

1414 Hwy 71 N
Alma, AR 72921-4723
Phone (479) 632-0321

210 Rice St
Berryville, AR 72616-4388
Phone (870) 423-6789

3317 N Wimberly Dr
Fayetteville, AR 72703-4056
Phone (479) 521-2752

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Springdale, AR, CCN 047170
  • Elite Home Health Home health agency, Springdale, AR, CCN 047346
  • Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004
  • Siloam Springs Regional Hospital Hospital, Siloam Springs, AR, CCN 040001
  • Northwest Medical Center-Springdale Hospital, Springdale, AR, CCN 040022
  • Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010
  • Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

Merit-based Incentive Payment System (MIPS)

Final score
91.41 of 100Reported as apm
Quality
79.26
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement93
Knee replacement111
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Orthopaedics, P.a. Adult Reconstructive Orthopaedic Surgery CurrentSince Aug 16, 2021 Accepting new patients
Ozark Orthopaedics, PA Adult Reconstructive Orthopaedic Surgery CurrentSince Aug 16, 2021 Accepting new patients
Ozark Orthopaedics, P.a. Adult Reconstructive Orthopaedic Surgery Past Accepting new patients

Locations

1800 SE Moberly Ln
Bentonville, AR 72712
Phone (479) 521-2752

3317 N Wimberly Dr
Fayetteville, AR 72703
Phone (479) 521-2752

603-2 N Progress Ave
Ste 600
Siloam Springs, AR 72761
Phone (479) 524-6188

603-2 N Progress Ave
Ste 600
Siloam Springs, AR 72761
Phone (479) 521-2752

Interoperability endpoints

  • Direct secure messaging: jcreech23175@washingtonregional.direct-ci.com
  • Direct secure messaging: jcreech62116@direct.llu.edu
  • Direct secure messaging: jonathan.creech.1@18403.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/18403/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1922495779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 N WIMBERLY DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034056",
            "telephone_number": "479-521-2752",
            "fax_number": "479-521-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 N WIMBERLY DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034056",
            "telephone_number": "479-521-2752",
            "fax_number": "479-521-4603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603-2 N Progress Ave Ste 600",
            "address_purpose": "LOCATION",
            "city": "Siloam Springs",
            "state": "AR",
            "postal_code": "727614610",
            "country_code": "US",
            "telephone_number": "479-521-2752",
            "fax_number": "479-521-4603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 SE Moberly Ln",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727127017",
            "country_code": "US",
            "telephone_number": "479-521-2752",
            "fax_number": "479-521-4603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CREECH",
        "first_name": "JONATHAN",
        "middle_name": "DALE EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-20",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "AR",
            "license": "E-14444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jonathan.creech.1@18403.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "direct messaging to Athena",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3317 N Wimberly Dr",
            "city": "Fayetteville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727034056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.