John D Spears, D.O.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

2003031159 Issued in MO

Practice address

1616 Southridge Dr
Ste 202
Jefferson City, MO 65109-5677

Phone

(573) 635-0401

Fax

(573) 635-6715

NPI assigned

Sep 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1043315385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 SOUTHRIDGE DR",
            "address_2": "STE 202",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095677",
            "telephone_number": "573-635-0401",
            "fax_number": "573-635-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 SOUTHRIDGE DR",
            "address_2": "STE 202",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095677",
            "telephone_number": "573-635-0401",
            "fax_number": "573-635-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEARS",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MO",
            "license": "2003031159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208747808",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mayleen Yandell Soto, LPC
• David A Spadavecchia, MD
• Brin N. Spaunhorst, LPC
• Speak-Easy, LLC
• Kathleen Spear, MED., BCBA, LBA
• Spine Midwest, Inc
• Patrick G. Sporleder, D.O.
• Molly Sportsman
• James Spraggs
• Spring Grove Counseling

• Orthopaedic Surgery of the Spine Physician in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Orthopaedic Surgery of the Spine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.