KELLIE MARIE CREASER (DNP, PMHNP-BC, FNP-C) – Psychiatric/Mental Health Nurse Practitioner, NPI 1740821453

KELLIE MARIE CREASER (DNP, PMHNP-BC, FNP-C) is a healthcare provider. based in Brookings, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP, PMHNP-BC, FNP-C. They hold a License No. 201908534NP-PP (OR). The NPI Number for KELLIE MARIE CREASER (DNP, PMHNP-BC, FNP-C) is 1740821453

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
KELLIE MARIE CREASER (DNP, PMHNP-BC, FNP-C)
NPI
1740821453
Phone
(541) 412-2000
Address
500 5TH ST
Enumeration Date
3 October 2019
Last Update Date
22 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5413519149
Graduation Year
2019 (7 years ago)
PAC ID
9739516972
Professional Enrollment ID
I20200227001348
Address ID
OR974158010BR648XXAVEX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness85
Years active:6State licenses:1Digital endpointsOther names

3,379 NURSE PRACTITIONER in OR

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Provider Addresses for KELLIE MARIE CREASER (DNP, PMHNP-BC, FNP-C)

  • 500, 5th Street, Brookings, Brookings County, South Dakota, 57006, United States

    BROOKINGS, OR 974159702

    Phone: (541) 412-2000

    Fax: (541) 412-2081

    Type: Mailing

  • 840 HASSETT ST

    BROOKINGS, OR 974157201

    Phone: (541) 351-9149

    Fax: (503) 914-6686

    Type: Mailing

  • 648 CHETCO AVE

    BROOKINGS, OR 974158010

    Phone: (541) 351-9149

    Fax: (503) 914-6686

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $136.

Total Amount is formed as General ($136) + Research ($0) + Ownership ($0) = $136.

Last reported payment date: 2024-11-26 • Largest payer in this snapshot: ABBVIE INC. ($69).

Total Amount

$136

General + Research + Ownership

Payments

5

Total payment records

General Amount

$136

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-26

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-02-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200227001348INurse PractitionerORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97415)

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Reviews

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Frequently asked questions

What NPI should I save for KELLIE MARIE CREASER (DNP, PMHNP-BC, FNP-C)?
Save NPI 1740821453 if you need a stable reference for KELLIE MARIE CREASER (DNP, PMHNP-BC, FNP-C).
Does this profile mean KELLIE MARIE CREASER (DNP, PMHNP-BC, FNP-C) is currently active?
Yes — KELLIE MARIE CREASER (DNP, PMHNP-BC, FNP-C) appears active in the national provider directory.
What kind of provider is KELLIE MARIE CREASER (DNP, PMHNP-BC, FNP-C)?
The page reflects Psychiatric/Mental Health Nurse Practitioner for KELLIE MARIE CREASER (DNP, PMHNP-BC, FNP-C). Clinical services aligned with this taxonomy classification.
Where is KELLIE MARIE CREASER (DNP, PMHNP-BC, FNP-C)'s primary listing?
We display Brookings, Oregon because that is what the record indicates for KELLIE MARIE CREASER (DNP, PMHNP-BC, FNP-C).
What if Brookings, Oregon seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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