Active NPI
Marie McCreary, DC
- Chiropractor
- Ventura, CA
National Provider Identifier
1952454399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC21429
- Practice address
- 1655 Mesa Verde Ave
#100
Ventura, CA 93003-6518 - Phone
- (805) 650-9665
- Fax
- (805) 650-9665
- NPI assigned
- Jan 19, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC21429 | CA | Primary |
Addresses
Primary practice location
1655 Mesa Verde Ave
#100
Ventura, CA 93003-6518
Mailing address
PO Box 5805
Ventura, CA 93005-0805
Phone (805) 650-9665
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC214291 | Other | CA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120206000373 | CA | Practitioner - Chiropractic | 3476710310 | Practice locations: Ventura, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC21429 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952454399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5805",
"city": "VENTURA",
"state": "CA",
"postal_code": "930050805",
"telephone_number": "805-650-9665",
"fax_number": "805-650-9665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1655 MESA VERDE AVE",
"address_2": "#100",
"city": "VENTURA",
"state": "CA",
"postal_code": "930036518",
"telephone_number": "805-650-9665",
"fax_number": "805-650-9665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCREARY",
"first_name": "MARIE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC21429",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "DC214291",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.