John V Spence, M.D.

Primary specialty

Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X

License

55572 Issued in GA

Practice address

101 Harris Industrial Blvd
Suite E
Vidalia, GA 30474-8852

Phone

(770) 309-6636

Fax

(912) 277-2080

NPI assigned

Jul 31, 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

Enrolled in GA

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

Specialty

Emergency Medicine

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Health Meadows Hospital Hospital, Vidalia, GA, CCN 110128
• Emanuel Medical Center Hospital, Swainsboro, GA, CCN 110109

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Georgia Hyperbaric and Wound Consulting, LLC

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Vidalia, GA
  • NPI 1114224631

  GA, Undersea and Hyperbaric Medicine

  Medicare reassignment NPD Authorized official
• Advanced Pediatric Specialists LLC

  • Pediatrics Physician
  • Savannah, GA
  • NPI 1073046397
  NPD (past)
• Floyd Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Rome, GA
  • NPI 1811907124
  NPD (past)
• Georgia Emergency Associates

  • Emergency Medicine Physician
  • Rincon, GA
  • NPI 1528098290
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Emanuel County Hospital Authority

  • Rural Acute Care Hospital
  • Swainsboro, GA
  • NPI 1235129214

  Hospital

  Care Compare affiliation
• Vidalia Health Services, LLC

  • General Acute Care Hospital
  • Vidalia, GA
  • NPI 1790376564

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1124034996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HARRIS INDUSTRIAL BLVD",
            "address_2": "SUITE E",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748852",
            "telephone_number": "912-277-2077",
            "fax_number": "912-277-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HARRIS INDUSTRIAL BLVD",
            "address_2": "SUITE E",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748852",
            "telephone_number": "770-309-6636",
            "fax_number": "912-277-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "JOHN",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "GA",
            "license": "55572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880364664A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeastern Cardiovascular Img, Inc.
• Southern Chiro Vidalia, LLC
• Southern Choices LLC
• Southern Community Hospice, Inc.
• Southern Magnolia Personal Care Home
• Charles M Spivey, MD
• John Casey Spivey, MD
• Carl Leland Stalvey, M.D.
• Kristin Nicole Stanford, PHARMD
• Leann Davis Stanley, M.ED.CCCSLP

• All providers in Vidalia, GA
• Undersea and Hyperbaric Medicine (Emergency Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.