Active NPI
Jason Spears, D.D.S.
- General Practice Dentistry
- Port Charlotte, FL
National Provider Identifier
1053737049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN 20514
- Practice address
- 4300 Kings Hwy
Suite 500
Port Charlotte, FL 33980-2917 - Phone
- (239) 344-2337
- Fax
- (941) 629-2365
- NPI assigned
- Mar 13, 2014
- Last updated
- May 4, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN 20514 | FL | Primary |
Addresses
Primary practice location
4300 Kings Hwy
Suite 500
Port Charlotte, FL 33980-2917
Mailing address
PO Box 1357
Fort Myers, FL 33902-1357
Phone (239) 278-3600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 011672400 | Medicaid | FL |
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151207002835 | FL | Order and Referring Only - Dentist | 3476853805 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 20514 | FL | MD | General Practice Dentistry |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493856000000",
"number": "1053737049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1357",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339021357",
"telephone_number": "239-278-3600",
"fax_number": "239-226-4650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 KINGS HWY",
"address_2": "SUITE 500",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339802917",
"telephone_number": "239-344-2337",
"fax_number": "941-629-2365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEARS",
"first_name": "JASON",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-13",
"last_updated": "2017-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN 20514",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "011672400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Charlotte, FL
- Sovi Joseph MD PA
- Joseph William Spadafora, D.O.
- Chelsea Spalding, O.D.
- Lewis Douglas Spangler, M.D.
- David Stephen Sparrow
- Special Care Transportation LLC
- Special Needs Ride With Ease & Horses for Our Heroes
- Special Training & Rehabilitation of Charlotte County Inc
- Special Training & Rehabilitation of Charlotte County, Inc.
- Sean Anthony Spence, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; 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.