Individual provider Active NPI

M Ann Spillan, DO

  • Psychiatry Physician
  • Caro, MI
National Provider Identifier
1083769459
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A5975 Issued in CA
Practice address
830 Allen St
Caro, MI 48723-1486
Phone
(231) 510-3645
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 10019 MT
Psychiatry Physician 2084P0800X 510101324 MI
Psychiatry Physician 2084P0800X 20A5975 CA Primary

Addresses

Primary practice location

830 Allen St
Caro, MI 48723-1486

Mailing address

830 Allen St
Caro, MI 48723-1486
Phone (231) 510-3645

Other practice location 1

4411 E Kings Canyon Rd
Fresno, CA 93702-3604
Phone (559) 246-5023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A5975CAMDPsychiatry Physician
510101324MIMDPsychiatry Physician
10019MTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma Regional Medical Center CurrentSince Feb 20, 2023 Accepting new patients
Yuma Regional Medical Center CurrentSince Feb 20, 2023 Accepting new patients
State of Michigan Office of Financial Management PastSince Mar 18, 2015 Accepting new patients

Locations

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1083769459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 ALLEN ST",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487231486",
            "telephone_number": "231-510-3645",
            "fax_number": "406-494-7593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 ALLEN ST",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487231486",
            "telephone_number": "231-510-3645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4411 E Kings Canyon Rd",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937023604",
            "country_code": "US",
            "telephone_number": "559-246-5023",
            "fax_number": "559-512-8705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPILLAN",
        "first_name": "M ANN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MT",
            "license": "10019",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "510101324",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A5975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caro, MI

Sources for this page

Verify at the official NPI Registry.