Individual provider Active NPI

Amy Leigh Creed, RN

  • Registered Nurse
  • Tyler, TX
National Provider Identifier
1962004697
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
780755 Issued in TX
Practice address
11581 Hollyridge Dr
Tyler, TX 75703-7811
Phone
(903) 279-9556
NPI assigned
Nov 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 780755 TX Primary

Addresses

Primary practice location

11581 Hollyridge Dr
Tyler, TX 75703-7811

Mailing address

11581 Hollyridge Dr
Tyler, TX 75703-7811
Phone (903) 279-9556

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
780755TXMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1962004697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11581 HOLLYRIDGE DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757037811",
            "telephone_number": "903-279-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11581 HOLLYRIDGE DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757037811",
            "telephone_number": "903-279-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREED",
        "first_name": "AMY",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "780755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.