Mary Theresa Wild Crea, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

38767 Issued in MN

Practice address

5975 Carmen Ave
Inver Grove Heights, MN 55076-4416

Phone

(651) 455-9697

Fax

(651) 455-2012

NPI assigned

Jul 29, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Clinics

  • Medical Specialty Clinic/Center
  • Burnsville, MN
  • NPI 1508050543
  NPD

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1982604096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1286 RAYMOND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081820",
            "telephone_number": "651-455-9697",
            "fax_number": "651-455-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5975 CARMEN AVE",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550764416",
            "telephone_number": "651-455-9697",
            "fax_number": "651-455-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD CREA",
        "first_name": "MARY",
        "middle_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "38767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lynn Weinzirl, LPN
• Well Med, PA
• Well Medical PA
• Dean Kevin Wennerberg, A.T.,C
• Juliana Malone White, PT
• Lindsey Nicole Williams
• Shontel Wilson, ARNP
• Allison Leah Wong, M.D.
• Whitney P Worley, PA-C
• See Yang

• Specialist in Inver Grove Heights, MN
• Providers in Inver Grove Heights, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.

Verify at the official NPI Registry.