Individual provider Active NPI

Robert C Sprecher, MD

  • Pediatric Otolaryngology Physician
  • Jacksonville, FL
National Provider Identifier
1033139480
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
ME111289 Issued in FL
Practice address
807 Childrens Way
Nemours Childrens Clinic, Jacksonville
Jacksonville, FL 32207-8426
Phone
(904) 697-3694
Fax
(904) 697-3927
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 35-069095 OH
Pediatric Otolaryngology Physician 207YP0228X ME111289 FL Primary

Addresses

Primary practice location

807 Childrens Way
Nemours Childrens Clinic, Jacksonville
Jacksonville, FL 32207-8426

Mailing address

P.O. Box 5720
Provider Enrollment Department
Jacksonville, FL 32247-5720
Phone (407) 650-7129

Other identifiers 8

IdentifierTypeStateIssuer
364038OtherOHWELLCARE
0000000206511OtherOHUNISON
000000506212OtherOHANTHEM
000000132426OtherOHANTHEM
0019465310002MedicaidPA
5741197OtherOHAETNA
0231556MedicaidOH
733289OtherOHBUCKEYE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120113000389 FL Practitioner - Otolaryngology 3577516780 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-069095OHMDOtolaryngology Physician
ME111289FLMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Nov 21, 2011 Accepting new patients
The Nemours Foundation CurrentSince Nov 21, 2011 Accepting new patients

Locations

14785 Old St Augustine Rd
Jacksonville, FL 32258
Phone (904) 292-1808

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

Interoperability endpoints

  • Direct secure messaging: rsprecher36615@direct.nemours.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1033139480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 5720",
            "address_2": "PROVIDER ENROLLMENT DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322475720",
            "telephone_number": "407-650-7129",
            "fax_number": "407-650-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 CHILDRENS WAY",
            "address_2": "NEMOURS CHILDRENS CLINIC, JACKSONVILLE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078426",
            "telephone_number": "904-697-3694",
            "fax_number": "904-697-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRECHER",
        "first_name": "ROBERT",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35-069095",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "FL",
            "license": "ME111289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "364038",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "0000000206511",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000506212",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000132426",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019465310002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5741197",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0231556",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "733289",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.